Evidence map›Paper›PMID 34227029›Full record

SynthesisHeart failure reviews2022

Prognostic value of natriuretic peptides in heart failure: systematic review and meta-analysis.

Tayler A Buchan, Crizza Ching, Farid Foroutan, Abdullah Malik, Julian F Daza, Nicholas Ng Fat Hing, Reed Siemieniuk, Nathan Evaniew, Ani Orchanian-Cheff, Heather J Ross and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Heart failure reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  6. Observational
  7. Article
  8. Article
  9. Review
  10. Article
  11. Current and novel biomarkers in cardiogenic shock.European journal of heart failure · 2025
    Review
  12. Observational
  13. Observational
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Tayler A BuchanTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Crizza ChingTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Farid ForoutanTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Abdullah MalikTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Julian F DazaDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Nicholas Ng Fat HingTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Reed SiemieniukDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Nathan EvaniewDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Ani Orchanian-CheffTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Heather J RossTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada.
Gordon GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Ana C AlbaTed Rogers Center for Heart Research, University Health Network, Toronto, ON, Canada. carolina.alba@uhn.ca.
University Health Network · CAMcMaster University · CAImpact · CATed Rogers Centre for Heart Research · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Risk models, informing optimal long-term medical management, seldom use natriuretic peptides (NP) in ascertaining the absolute risk of outcomes for HF patients. Individual studies evaluating the prognostic value of NPs in HF patients have reported varying effects, arriving at best estimates requires a systematic review. We systematically summarized the best evidence regarding the prognostic value of brain natriuretic peptide (BNP) and NT-proBNP in predicting mortality and hospitalizations in ambulatory heart failure (HF) patients. We searched bibliographic databases from 2005 to 2018 and included studies evaluating the association of BNP or NT-proBNP with mortality or hospitalization using multivariable Cox proportional hazard models. We pooled hazard ratios using random-effect models, explored heterogeneity using pre-specified subgroup analyses, and evaluated the certainty of evidence using the Grading of Recommendations and Development Evaluation framework. We identified 67 eligible studies reporting on 76,178 ambulatory HF patients with a median BNP of 407 pg/mL (261-574 pg/mL). Moderate to high-quality evidence showed that a 100-pg/mL increase in BNP was associated with a 14% increased hazard of mortality (HR 1.14, 95% CI 1.06-1.22); a 1-log-unit increase was associated with a 51% increased hazard of mortality (HR 1.51, 95% CI 1.41-1.61) and 48% increased hazard of mortality or hospitalization (HR 1.48, 95% CI 1.29-1.69). With moderate to high certainty, we observed a 14% independent relative increase in mortality, translating to a clinically meaningful increase in absolute risk even for low-risk patients. The observed associations may help in developing more accurate risk models that incorporate NPs and accurately prognosticate HF patients.

Indexed as

Heart FailureHospitalizationHumansNatriuretic PeptidesPrognosisNatriuretic PeptidesAmbulatoryBrain natriuretic peptideHeart failureHospitalizationMeta-analysisMortalityPrognosis

Identifiers

PMID34227029
OpenAlexW3182219078

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.