For proven natriuretic peptides, still much to be learned

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Karen Titus

November 2015—Natriuretic peptides could well be the Western canon of heart failure markers. The search for newer, perhaps more relevant, biomarkers continues (see related story), but BNP and NT-proBNP remain worthy of study.

In their more classic roles, they are used to recognize heart failure as well as to stratify risk, where higher concentrations of either biomarker indicate a higher risk for complications, says cardiologist James Januzzi Jr., MD.

But physicians are continuing to mine new meaning from these markers as well. “We’re beginning to recognize that they might be useful for making decisions about therapeutic adjustments,” says Dr. Januzzi, the Hutter Family professor of medicine, Harvard Medical School, and senior faculty at the Harvard Clinical Research Institute. “Patients with elevated concentrations of either BNP or NT-proBNP may be specifically targeted with more aggressive heart failure therapy adjustments, with the idea that these patients have a higher likelihood for complications, and thus more to gain, from therapy intervention.”