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Update on current practice in laboratory medicine in respect of natriuretic peptide testing for heart failure diagnosis and management in Europe. The CARdiac MArker Guideline Uptake in Europe (CARMAGUE) study.

Hammerer-Lercher, A; Gruson, D; Stankovic, S; Collinson, P; Suvisaari, J; Pulkki, K; Duff, CJ; Baum, H; Stavljenic-Rukavina, A; Aakre, KM; et al. Hammerer-Lercher, A; Gruson, D; Stankovic, S; Collinson, P; Suvisaari, J; Pulkki, K; Duff, CJ; Baum, H; Stavljenic-Rukavina, A; Aakre, KM; Langlois, MR; Laitinen, P; EFLM Task Group Cardiac Markers. (2020) Update on current practice in laboratory medicine in respect of natriuretic peptide testing for heart failure diagnosis and management in Europe. The CARdiac MArker Guideline Uptake in Europe (CARMAGUE) study. Clin Chim Acta, 511. pp. 59-66. ISSN 1873-3492 https://doi.org/10.1016/j.cca.2020.09.030
SGUL Authors: Collinson, Paul

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Abstract

BACKGROUND: The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) initiated the CArdiac MARker Guidelines Uptake in Europe (CAMARGUE) Study to survey if current biomarker testing for heart failure (HF) in Europe is in accordance with up-dated guidelines. METHODS: A web-based questionnaire was distributed to clinical laboratories via European biochemical societies in 2019. Questions covered the type of natriuretic peptide (NP) assays performed, decision limits for HF, and opinion concerning requirement of different thresholds in patients with renal failure or obesity. RESULTS: There were 347 participating laboratories mostly from European countries with 266 offering NP testing. NP testing was increased from 67% to 77% between 2013 and 2019. NT-proBNP remained the preferred biomarker. Recommended decision limits were implemented for BNP (85%) and better focused for NT-proBNP (40%) than in the previous survey. The survey revealed that laboratorians are willing to support the translation of adjusted cut-off values for age, gender and for patients with conditions like renal insufficiency. CONCLUSION: Guidelines stimulate clinical laboratories to offer NP testing with high value for the diagnosis and management of HF, and to present adjusted medical decision limits. Future guidelines should encourage the use of personalized cut-offs for some confounding factors.

Item Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: B-type natriuretic peptide, N-terminal B-type natriuretic peptide, biomarkers, follow-up, guideline implementation, heart failure, laboratory practice, EFLM Task Group Cardiac Markers, General Clinical Medicine, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Clin Chim Acta
ISSN: 1873-3492
Language: eng
Dates:
DateEvent
December 2020Published
28 September 2020Published Online
21 September 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 33002472
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112522
Publisher's version: https://doi.org/10.1016/j.cca.2020.09.030

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