Using individualized levels of the biomarker NT-proBNP to guide the treatment of patients with chronic heart failure did not improve their morbidity or mortality over standard clinical management, according to results of the Can Pro-Brain-Natriuretic Peptide Guided Therapy of Chronic Heart Failure Improve Heart Failure Morbidity and Mortality? (PRIMA) study presented here at the American College of Cardiology 2009 Scientific Sessions.
In this study protocol an algorithmic approach triggered an immediate intensification of heart failure treatment any time a patient’s proBNP value exceeded an individualized target. This result is in line with previous research.
Although the study did not validate the use of proBNP as a direct trigger for intervention it did confirm its usefulness as a prognostic marker, as patients who stayed in their target range had better outcomes.
This study does not negate proBNP as a marker to follow in heart failure. What it does tell us is that we are not sure how to optimally use it.