Biomarker guided therapy for heart failure: focus on natriuretic peptides

The management of heart failure remains challenging despite many therapeutic advances. Rigorous clinical trial evidence supports administration of multiple therapies, but utilization of evidence-based treatment remains inconsistent and suboptimal. Disease management programs appear effective, but re...

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Bibliographic Details
Published in:Heart failure reviews 2010-07, Vol.15 (4), p.351-370
Main Authors: Adams, Kirkwood F., Felker, G. Michael, Fraij, Ghassan, Patterson, J. Herbert, O’Connor, Christopher M.
Format: Article
Language:English
Subjects:
Area Under Curve
Biomarkers
Cardiology
Cardiotonic Agents - therapeutic use
Disease Management
Drug Monitoring - methods
Evidence-Based Medicine
Heart Failure - diagnosis
Heart Failure - drug therapy
Heart Failure - pathology
Humans
Medicine
Medicine & Public Health
Natriuretic Peptide, Brain
Natriuretic Peptides
Prognosis
Treatment Outcome
Troponin
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Summary:The management of heart failure remains challenging despite many therapeutic advances. Rigorous clinical trial evidence supports administration of multiple therapies, but utilization of evidence-based treatment remains inconsistent and suboptimal. Disease management programs appear effective, but remain costly and difficult to implement in today’s care system. Another approach involves optimizing therapy based on serial monitoring of cardiac biomarkers. Emerging results suggest that guiding therapy based on serial changes in natriuretic peptides may be an effective strategy. Although pilot work has provided encouraging results, appropriately designed, large-scale, prospective randomized trials are needed to confirm these preliminary findings and definitively establish this therapeutic approach.
ISSN:1382-4147
1573-7322
DOI:10.1007/s10741-009-9139-9