Table 2.

ACC 2017 BNP Guidelines

	COR, LOE	Recommendation	Updates from 2017
Recommendation for Prevention of HF	IIa, B-R	For patients at risk of developing HF, natriuretic peptide biomarker-based screening followed by team-based care, including a cardiovascular specialist optimizing GDMT, can be useful to prevent the development of left ventricular dysfunction (systolic or diastolic) or new-onset HF	NEW: New data suggest that natriuretic peptide biomarker screening and early intervention may prevent HF.
Recommendation for Diagnosis	I,A	In patients presenting with dyspnea, measurement of natriuretic peptide biomarkers is useful to support a diagnosis or exclusion of HF	MODIFIED: 2013 acute and chronic recommendations have been combined into a diagnosis section.
Recommendation for prognosis	I, A	Measurement of BNP or NT-proBNP is useful for establishing prognosis or disease severity in chronic HF
	I,A	Measurement of baseline levels of natriuretic peptide biomarkers and/or cardiac troponin on admission to the hospital is useful to establish a prognosis in acutely decompensated HF	MODIFIED: Current recommendation emphasizes that it is admission levels of natriuretic peptide biomarkers that are useful
	IIa, B-NR	During a HF hospitalization, a predischarge natriuretic peptide level can be useful to establish a postdischarge prognosis	NEW: Current recommendation reflects new observational studies.
	IIb, B-NR	In patients with chronic HF, measurement of other clinically available tests, such as biomarkers of myocardial injury or fibrosis, may be considered for additive risk stratification	MODIFIED: 2013 recommendations have been combined into prognosis section, resulting in LOE change from A to B-NR.