Biomarker Testing Considerations in the Evaluation and Management of Patients With Heart Failure: Perspectives From the International Federation of Clinical Chemistry and Laboratory Medicine Committee

Abstract

The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Committee on Clinical Applications of Cardiac Bio-Markers (C-CB) agree on the objective evidence that laboratory biomarkers can provide in the diagnosis of HF and support natriuretic peptides (NP; with b-type NP [BNP] and N-terminal pro-BNP [NT-proBNP] predominantly available from clinical laboratories) as the most well-documented and suitable biomarkers in this regard. We also believe it is important to highlight analytical issues that may affect the clinical interpretation of cardiac biomarkers, including the NPs. 1 Bozkurt B Coats AJ Tsutsui H Abdelhamid M Adamopoulos S Albert N et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. J Card Fail. 2021 Mar 1; (S1071-9164(21)00050-6)https://doi.org/10.1016/j.cardfail.2021.01.022 Google Scholar , 2 Mentz RJ Lala A. The universal definition of heart failure: perspectives from diverse stakeholders. J Card Fail. 2021; 27: 386 Google Scholar , 3 Wu AHB Christenson RH Greene DN Jaffe AS Kavsak PA Ordonez-Llanos J et al. Clinical laboratory practice recommendations for the use of cardiac troponin in acute coronary syndrome: expert opinion from the Academy of the American Association for Clinical Chemistry and the Task Force on Clinical Applications of Cardiac Bio-Markers of the International Federation of Clinical Chemistry and Laboratory Medicine. Clin Chem. 2018; 64: 645-655 Google Scholar , 4 Kavsak PA Lam CSP Saenger AK Jaffe AS Collinson P Pulkki K et al. Educational recommendations on selected analytical and clinical aspects of natriuretic peptides with a focus on heart failure: a report from the IFCC Committee on Clinical Applications of Cardiac Bio-Markers. Clin Chem. 2019; 65: 1221-1227 Google Scholar Accordingly, we have listed herein the first 5 of the 10 most current laboratory recommendations that clinicians should be cognizant of when ordering NP tests. 4 Kavsak PA Lam CSP Saenger AK Jaffe AS Collinson P Pulkki K et al. Educational recommendations on selected analytical and clinical aspects of natriuretic peptides with a focus on heart failure: a report from the IFCC Committee on Clinical Applications of Cardiac Bio-Markers. Clin Chem. 2019; 65: 1221-1227 Google Scholar Our aim is to highlight analytic issues of clinical relevance and provide recommendations to help clinicians optimally use NP values with respect to the universal definition of heart failure. To this end, we have listed the recommendations with corresponding text in the universal definition of heart failure to further clarify these important aspects.