Serial measurements of natriuretic peptide to assess pharmacological interventions and subsequent impact on cardiovascular risk stratification in heart failure: a precision medicine approach

Heart failure (HF) is a major worldwide epidemic associated with high morbidity and mortality, with the number of cases expected to increase in line with increasing average life expectancy (1). Progressive advances in medical science have allowed identification of blood-based biomarkers [e.g., B-type natriuretic peptide (BNP), N-terminal prohormone of BNP (NT-proBNP) and troponin] that are able to provide improved prognostic information for patients at risk of or following an HF event. However, their routine use for decision making at times is limited and shows challenging hurdles for precise risk stratification, such as emerging risks being affiliated with sub-clinical myocardial damage for use of troponin and/or inflammatory biomarkers (2) driving researchers to investigate a cocktail of biomarkers to improve risk prediction.