Amino-terminal pro-B-type natriuretic peptide testing in patients with diabetes mellitus and with systemic hypertension

Although the current value of amino-terminal pro-B-type natriuretic peptides (NT-proBNP) to generally screen populations of "apparently well patients" remains promising but still undefined, the use of NT-proBNP to screen patients at high risk for heart disease (such as elderly patients, or patients with diabetes mellitus, hypertension, or known coronary artery disease) appears logical and is supported by data. NT-proBNP has strong prognostic value in such at-risk patients. However, the exact implications for clinical management after detection of an elevated NT-proBNP value should be driven by clinical judgment. At present, data suggest that when an elevated NT-proBNP is detected in an at-risk patient, it is a high-risk finding. In this context, consideration for a more in-depth cardiovascular workup, as well as initiation or intensification of medical therapies with proven benefits might be indicated. (c) 2008 Elsevier Inc. All rights reserved.