Proposed Application Of Bnp In

At the present time, adequate data do not exist to define the proper role of BNP and NT-proBNP in stratifying patients to more aggressive interventional therapy, and the clinician must consider plasma levels of these peptides in the context of other biomarkers and clinical factors before assigning a patient to a proper level of care. More research is needed to identify appropriate pharmacological and interventional strategies for high-risk patients with ACS and elevated levels of BNP or NT-proBNP. In the meantime, we propose the algorithm in Fig. 7 for patients with ACS. Patients who present with ACS and have elevated cardiac troponin or who are in a high TIMI risk category have been shown to benefit from an early interventional approach. In patients with a low TIMI risk score who have a normal troponin result, aggressive intervention may be considered for those patients who have BNP levels >80 pg/mL (cut point based on studies using the Biosite and Bayer assays). Otherwise, a conservative approach may be pursued, with noninvasive testing. Regardless ofwhich ofthese approaches is taken, medical therapy with aspirin, angioten-sin-converting enzyme inhibitors, aldosterone antagonists, ^-blockers, and statins should

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