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Cardiovascular

What is the role of NT-proBNP in primary care?

Heart failure (HF) is common, associated with significant morbidity and mortality and frequent hospitalisations. Due to population growth, ageing and increased prevalence of related conditions, prevalence of HF and related hospital admissions is expected to rise significantly in the future.

HF symptoms are common, insidious and non-specific which presents a diagnostic challenge in the community, often leading to delay in diagnosis and appropriate management. Clinical guidelines recommend testing plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration early in the evaluation of patients with symptoms suggestive of acute or chronic heart failure (HF). Concentration below the well validated cut-off values allow HF to be confidently ruled out while high concentrations are useful in guiding further investigation, allowing GPs to determine which patients require expedited echocardiography referral.

NT-proBNP testing can thus empower the GP and provide important guidance for collaboration with secondary care. There is also good evidence that NT-proBNP has prognostic value, leading to an evolving role in guiding individualised HF management decisions. Elevated NT-proBNP in patients with type 2 diabetes has been associated with increased risk of developing cardiac disease. At present reimbursement for testing presents a barrier in some circumstances, but in future, NT-proBNP measurement in high risk populations may allow early targeted initiation of preventive measures.


This educational activity was developed by MdBriefCase, with funding from Roche Diagnostics.

DURATION

25 min

PROFESSION

Physician, Specialist

# OF CREDITS

0

ACCREDITATION

Unaccredited

EXPIRY DATE

2023-01-25

Heart failure (HF) is common, associated with significant morbidity and mortality and frequent hospitalisations. Due to population growth, ageing and increased prevalence of related conditions, prevalence of HF and related hospital admissions is expected to rise significantly in the future.

HF symptoms are common, insidious and non-specific which presents a diagnostic challenge in the community, often leading to delay in diagnosis and appropriate management. Clinical guidelines recommend testing plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration early in the evaluation of patients with symptoms suggestive of acute or chronic heart failure (HF). Concentration below the well validated cut-off values allow HF to be confidently ruled out while high concentrations are useful in guiding further investigation, allowing GPs to determine which patients require expedited echocardiography referral.

NT-proBNP testing can thus empower the GP and provide important guidance for collaboration with secondary care. There is also good evidence that NT-proBNP has prognostic value, leading to an evolving role in guiding individualised HF management decisions. Elevated NT-proBNP in patients with type 2 diabetes has been associated with increased risk of developing cardiac disease. At present reimbursement for testing presents a barrier in some circumstances, but in future, NT-proBNP measurement in high risk populations may allow early targeted initiation of preventive measures.


This educational activity was developed by MdBriefCase, with funding from Roche Diagnostics.

Faculty

Dr Anita Sharma (GP), MBBS, FRACGP
Queensland

Professor Andrew Sindone, B. Med (Hons), MD, FRACP, FCSANZ, FNHFA
New South Wales

Learning objectives

Understand how NT-proBNP can be used in primary care to

  1. Diagnose and monitor heart failure
  2. Identify those type 2 diabetes patients at higher risk of developing CVD in the next 12 months, who can then receive cardioprotective treatment and/or referral to a Cardiologist
Cost of course:  
Free
# of credits: 0
Duration: 25 min

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