Guidance

23 November, 2021

Guidance published: Natriuretic peptides to rule-in and rule-out a diagnosis of heart failure in adults in the emergency department setting

Health Technology Wales has today published national guidance on Natriuretic peptides to rule-in and rule-out a diagnosis of heart failure in adults in the emergency department setting.  

We appraised the clinical and cost effectiveness of Natriuretic peptides in the emergency department setting. 

The evidence supports the routine adoption of N-terminal pro B-type natriuretic peptide (NT-proBNP) measurement to rule-in and rule-out acute heart failure in adults presenting to the emergency department in whom there is clinical suspicion of this diagnosis.

The addition of NT-proBNP measurement to routine clinical assessment may reduce length of hospital stay and the rate of re-hospitalisations.

Health economic modelling indicates that NT-proBNP to rule-in and rule-out acute heart failure is the most cost-effective strategy.

The status of our Guidance is that NHS Wales should adopt this guidance or justify why it has not been followed. We will evaluate the adoption and impact of our Guidance.

We’ve published Guidance, an Evidence Appraisal Report (EAR), a Topic Exploration Report and a plain language summary for this topic. Click here to read about this topic.

HTW Appraisal Panel considers appraisal evidence within the context of NHS Wales and produces the HTW Guidance. The panel also helps us to identify important topics, evaluates the uptake of guidance and facilitates stakeholder engagement. It has pan-Wales and multi-disciplinary representation. Learn more about our Appraisal Process here.