MULTIMODAL TREATMENT OF HEART FAILURE BASED ON PROGNOSTIC ASSESSMENT AND THERAPEUTIC APPROACH SUPPORTED BY THE BIOCHEMICAL MARKERS BNP AND NT-PROBNP

Introduction: Heart failure (HF) is a complex and prevalent clinical syndrome characterized by the heart's inability to meet metabolic tissue demands. Early diagnosis and risk stratification are crucial, as late recognition leads to irreversible ventricular remodeling and increased mortality. Objective: To evaluate the effect of a multimodal therapeutic approach to heart failure based on prognostic stratification and the monitoring of BNP and NT-proBNP biomarkers. Methodology: An integrative review was conducted using strategic descriptors, aiming to include only relevant studies for understanding the role of biomarkers in the therapeutic approach to heart failure. Results: The data revealed that elevated BNP/NT-proBNP levels correlate with greater wall stress and poorer prognosis, regardless of the LVEF phenotype. Trials such as PARADIGM-HF and PIONEER-HF demonstrated that sacubitril/valsartan therapy promotes significant reductions in these biomarkers (approximately 25%), outperforming conventional treatments and reducing hospitalizations. Discussion: Early reduction of NT-proBNP acts as a dynamic marker of therapeutic response, although factors such as age, obesity, and renal function must be considered when interpreting cutoff points. The multimodal approach, by integrating biomarkers into clinical management, allows for more precise therapeutic adjustments. Conclusion: Serial monitoring of natriuretic peptides is indispensable for guiding multimodal therapy, optimizing clinical outcomes, and improving the quality of life for patients with HF.