Role of Cardiac Biomarkers in Cardiovascular Disease Diagnosis and Management

Cardiac Biomarkers

BNP and NT-proBNP are the most established biomarkers for heart failure diagnosis, with primary utility in confirming or refuting the diagnosis of heart failure and stratifying long-term risk profiles 3, 4
BNP/NT-proBNP levels increase in response to ventricular wall tension due to pressure and volume overload, making them reliable indicators of cardiac dysfunction 4
The American Heart Association recommends BNP/NT-proBNP testing for heart failure diagnosis, particularly in the emergency department when the cause of dyspnea is unclear 7
Troponin elevation in heart failure, even without acute coronary syndrome, indicates increased risk 6
ANP is released primarily from atrial tissue in response to atrial stretch, and mid-regional pro-A-type natriuretic peptide has emerged as a potential biomarker in heart failure assessment 2, 3

Elevated BNP/NT-proBNP levels in heart failure patients correlate with increased mortality and hospitalization risk 5
Changes in BNP/NT-proBNP levels during treatment correlate with differences in long-term clinical outcomes 5
The American College of Cardiology recommends serial BNP/NT-proBNP measurements to track treatment response, with successful treatment resulting in measurable decreases in levels 6
BNP/NT-proBNP-guided therapy may be beneficial in specialized heart failure centers with structured disease management programs 6

Soluble suppressor of tumorigenicity 2 (sST2), galectin-3, and growth differentiation factor 15 (GDF-15) are emerging biomarkers for heart failure assessment 1, 2
High-sensitivity C-reactive protein (hsCRP) and other inflammatory markers may provide additional risk stratification in cardiovascular disease 3