Brain Natriuretic Peptide in Clinical Trials: Why This Matters for Practitioners

Brain Natriuretic Peptide in Clinical Trials: Why This Matters for Practitioners Posted By:
...

As we look to improve the treatment and quality of life of our patients with heart failure, we often use relevant labs to help us determine the extent of the disease. In addition, the use of clinical trials helps us understand how lab values can influence treatment options and therapies for our patients. An example of this is brain natriuretic peptide, or BNP, and N-terminal-proBNP (NT-proBNP). The measurement of this biomarker allows an understanding of the stretch receptors in cardiac tissue that can be released when volume overload is happening, which signifies worsening heart failure. However, clinical trials have been erratic in their use of measuring BNP, and there is no standard consensus on how it should be used as an inclusion criteria for these trials. In the May 2020 issue of the Journal of the American College of Cardiology: Heart Failure, a position paper researched this problem and has come up with suggestions to improve the inclusion criteria for trials. Within this document, the researchers have made some solid recommendations that will help future research to standardize the criteria for inclusion of patients and their BNP levels. These recommendations include:

  • Ensure enrollment of patients who have an accurate diagnosis of heart failure
  • Ensure enrollment of patients with acute heart failure who are presenting with nonspecific symptoms
  • Adjust BNP levels for special populations (eg, atrial fibrillation, renal failure, elderly, obese)
  • Adjust BNP concentrations for the desired event rates of the trials

Why does this matter to all of us? The trials that we depend on to give us the best, up to date information and treatment options must be inclusive and representative of our patients. A standard approach to inclusion criteria gives us the best chance to ensure the research will better represent our patient populations.

These recommendations can positively impact the way clinical trials use BNP and NT-proBNP inclusion criteria and improve the overall research process. Having a standardized inclusion criteria for patient population in these studies will hopefully improve our ability to care for our patients with heart failure.

References
  • Ibrahim NE, Burnett JC, Butler J, et al. Natriuretic peptides as inclusion criteria in clinical trials: A JACC: Heart Failure position paper. JACC: Heart Failure. 2020;8:347-358.

Share

Filed under: Cardiometabolic

Sign up to receive posts from The Exchange

Related
Atrial Fibrillation: Optimizing Outcomes by Addressing Social Determinants of Health and Implicit Bias

Atrial Fibrillation: Optimizing Outcomes by Addres ...

Atrial fibrillation (AF) is the most common sustained arrhythmia diagnosed, and its prevalence is ex ...

Filed under: Cardiometabolic, NPs & PAs


Continue Reading
My Experience With GLP-1 Receptor Agonists in Patients With Type 2 Diabetes

My Experience With GLP-1 Receptor Agonists in Pati ...

When considering the benefits of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) for our pat ...

Filed under: Cardiometabolic, NPs & PAs


Continue Reading
Dietary Sodium Restriction in Patients With Heart Failure

Dietary Sodium Restriction in Patients With Heart ...

There are about 6.2 million adults in the United States living with heart failure (HF), according to ...

Filed under: Cardiometabolic, Pulmonary Medicine


Continue Reading
Bleeding Risk with Apixaban and Systemic Fluconazole Use

Bleeding Risk with Apixaban and Systemic Fluconazo ...

We, as healthcare professionals, are aware that we must check for drug interactions in our patients ...

Filed under: Cardiometabolic, Pulmonary Medicine


Continue Reading
Cardiovascular Risk in Rheumatic Inflammatory Disease

Cardiovascular Risk in Rheumatic Inflammatory Dise ...

It is well documented that those with rheumatic inflammatory diseases have an increased risk of card ...

Filed under: Cardiometabolic, Rheumatology


Continue Reading
The Latest on Heart Failure: Clinical Trials Summary

The Latest on Heart Failure: Clinical Trials Summa ...

Too often, we are faced with hectic workdays that lead into hectic home lives—when we clock ou ...

Filed under: Cardiometabolic


Continue Reading