Use Of Bnp For Inpatient Management Of Heart Failure

There are approx 1 million admissions annually to US hospitals for heart failure. Patients admitted to the hospital with decompensated heart failure often have improvement in symptoms with the various treatment modalities available. However, readmission after hospitalization for heart failure is surprisingly common, estimated at 44% at 6 mo within the Medicare population, and challenging to predict (56). Considering that hospitalization is the principal contributor to the cost of patient care (70-75% of the total direct costs) (57), a reduction in heart failure hospitalizations would reduce morbidity for the patient as well as costs to society.

The use of BNP for targeting treatment of patients with heart failure is under active investigation. Targeting treatment of disease to specific biomarkers has precedent: treatment of hypertension is targeted to blood pressure, diabetes to blood glucose, and dys-lipidemia to lipid levels. The fact that BNP has a short half-life; is conveniently measured; and is a surrogate for wedge pressure, volume, NYHA functional class, and prognosis suggests its potential as a guide to therapy in heart failure.

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