Don-Wauchope Andrew C, McKelvie Robert S
Department of Pathology and Molecular Medicine, McMaster University and Hamilton Regional Laboratory Medicine Program, Hamilton, Ontario, Canada.
Division of Cardiology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Clin Biochem. 2015 Mar;48(4-5):236-46. doi: 10.1016/j.clinbiochem.2014.11.002. Epub 2014 Nov 8.
The B-type natriuretic peptides are now available on many automated clinical analysers. Clinical practice guidelines for heart failure include recommendations for where the B-type natriuretic peptides are possibly useful for clinical practice. A number of systematic reviews considering B-type natriuretic peptides in relation to heart failure patients have been published.
This review will consider the evidence presented in the systematic reviews and how this can be applied to clinical practice.
Twenty-six systematic reviews are summarised in tables considering applications to diagnostic, prognostic and guiding therapy. Important clinical considerations for these applications are discussed to facilitate appropriate implementation in the clinical laboratory.
Most clinical laboratories should be considering the appropriate implementation of the B-type natriuretic peptide as a diagnostic test to assist in ruling out heart failure. In the application of prognosis and guiding therapy a number of questions remain to be answered.
许多自动临床分析仪现在都可检测B型利钠肽。心力衰竭临床实践指南包含了关于B型利钠肽在临床实践中可能有用之处的建议。已经发表了一些关于心力衰竭患者B型利钠肽的系统评价。
本综述将考虑系统评价中呈现的证据以及如何将其应用于临床实践。
在考虑诊断、预后和指导治疗应用的表格中总结了26项系统评价。讨论了这些应用的重要临床注意事项，以促进在临床实验室中的适当实施。
大多数临床实验室应考虑适当实施B型利钠肽作为诊断试验，以协助排除心力衰竭。在预后和指导治疗的应用方面，仍有许多问题有待解答。
