Artikel

Peptide for Life

Peptide for Life - Closing the gap in biomarker access

It has been over 20 years since natriuretic peptides (NPs) were first introduced as biomarkers for the diagnosis of heart failure1,2. Even though NPs are recommended as initial diagnostic tests in patients with symptoms suggestive of HF in the current clinical practice guidelines of the European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA), the adoption of NPs among many countries is very limited3,4. The newly established Peptide for Life initiative aims to identify the barriers to guideline implementation and help close the gap in biomarker availability. 

Peptide for Life (PfL) is a spin-off project following the recent report of the Heart Failure Association (HFA) Atlas which unveiled stark disparities between the ESC member countries in the usage of NT-proBNP and proBNP in the emergency departments5,6. This initiative is a call to action to promote, educate and ultimately provide equal access to NPs in heart failure diagnosis and treatment across Europe. Within the framework of PfL, the ESC, HFA and National Heart Failure Societies (NHFS) will join forces to understand the reasons behind the low uptake of NPs and build clinical confidence in biomarkers as diagnostic tools in HF patient management. Several educational activities are planned, including clinical case mentoring and follow-up surveillance to identify and foster good clinical practices. The program has already been initiated in the Balkan area identified as the one with poorest access to NPs in Europe. 

It is important to note that the use of NPs in heart failure is not only beneficial to the patients but can also contribute to lowering the economic burden of HF for the healthcare system. It allows for faster initiation of the appropriate therapy, earlier discharge from the emergency department and contributes to lowering total treatment cost in the emergency department7-11.

It is high time to embrace the power of biomarkers and harness all the potential they have to offer. To learn more, listen to Prof. Antoni Bayes Genis, Prof. Petar Seferovic and Prof. Zlatko Fras talk about the Peptide for Life initiative.

Key facts
  • Despite recommendations from the ESC and AHA/ACC guidelines, in many countries natriuretic peptides (NPs) are not a part of the diagnostic toolkit in the emergency departments.
  • Peptide for Life is a call to action to promote, educate and ultimately enable equal access to NPs in heart failure (HF) diagnosis and treatment across Europe. 
  • European Society of Cardiology (ESC), Heart Failure Association (HFA) and National Heart Failure Societies (NHFS) join forces to understand the reasons behind the low uptake of NPs and build clinical confidence in biomarkers as diagnostic tools in HF patient management. 

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References

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  2. Maisel AS, et al. Breathing Not Properly Multinational Study Investigators. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002 Jul 18;347(3):161-7. doi: 10.1056/NEJMoa020233. 

  3. McDonagh TA, et al. ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. doi: 10.1093/eurheartj/ehab368. Erratum in: Eur Heart J. 2021 Oct 14.

  4. Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May 3;145(18):e876-e894. doi: 10.1161/CIR.0000000000001062. 

  5. Seferović PM, et al. National Heart Failure Societies of the ESC member countries (see Appendix). The Heart Failure Association Atlas: Heart Failure Epidemiology and Management Statistics 2019. Eur J Heart Fail. 2021 Jun;23(6):906-914. doi: 10.1002/ejhf.2143. 

  6. Bayes-Genis A, et al. The 'Peptide for Life' Initiative: a call for action to provide equal access to the use of natriuretic peptides in the diagnosis of acute heart failure across Europe. Eur J Heart Fail. 2021 Sep;23(9):1432-1436. doi: 10.1002/ejhf.2293.

  7. Pieske B, et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019 Oct 21;40(40):3297-3317. doi: 10.1093/eurheartj/ehz641. Erratum in: Eur Heart J. 2021 Mar 31;42(13):1274. 

  8. Chava R, et al. Multidisciplinary rounds in prevention of 30-day readmissions and decreasing length of stay in heart failure patients: A community hospital based retrospective study. Medicine (Baltimore). 2019 Jul;98(27):e16233. doi: 10.1097/MD.0000000000016233. 

  9. Hood SR, et al. Association Between Medication Adherence and the Outcomes of Heart Failure. Pharmacotherapy. 2018 May;38(5):539-545. doi: 10.1002/phar.2107.

  10. Ponikowski P, et al. ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016 Jul 14;37(27):2129-2200. doi: 10.1093/eurheartj/ehw128. Erratum in: Eur Heart J. 2016 Dec 30.

  11. Seferović PM, et al. Heart Failure Association Board of the European Society of Cardiology. Heart Failure Association of the European Society of Cardiology Quality of Care Centres Programme: design and accreditation document. Eur J Heart Fail. 2020 May;22(5):763-774. doi: 10.1002/ejhf.1784.