Importance of Rigorous Evaluation in Comparative Biomarker Studies

Following the introduction of B-type natriuretic peptide (BNP) and its amino-terminal equivalent (NT-proBNP), the use of biomarkers for the evaluation and management of heart failure (HF) has grown. Indeed, natriuretic peptide testing for diagnosis and prognosis recently earned a Class I Level of Evidence: A in the 2013 American Heart Association/American College of Cardiology clinical practice guidelines for HF (2). Although it took years to develop such support, this is indeed the proper recognition of the clinical role played by these important biomarkers.