National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Use of Cardiac Troponin and B-Type Natriuretic Peptide or N-Terminal proB-Type Natriuretic Peptide for Etiologies Other than Acute Coronary Syndromes and Heart Failure

Abstract

Over the past decade, cardiac troponin (cTn)1 has become the cornerstone laboratory medicine measurement for assessment of myocardial infarction (MI) in suspected acute coronary syndrome (ACS) patients. In the past 5–7 years, methods for measuring the natriuretic peptide B-type natriuretic peptide (BNP) and its inert cometabolite N-terminal proBNP (NT-proBNP) have become available, and much knowledge has accumulated regarding their clinical use in the context of heart failure and hemodynamic stress. In addition to ACS and heart failure, there are common and clinically important patient cohorts in whom these measurements can aid in diagnosis and management. For this reason, the National Academy of Clinical Biochemistry (NACB) formed a Laboratory Medicine Practice Guidelines (LMPG) committee to extend cardiac biochemical marker recommendations and establish modern guidelines for utilization …