Clinical recommendation	Evidence rating	References
BNP testing is recommended to detect or rule out heart failure, including diastolic heart failure. The test has a high negative predictive value—a negative result rules out disease more effectively than a positive result rules in disease.	C	24
BNP testing is a useful tool in predicting prognoses in patients with heart failure and appears to be a stronger predictor than some traditional indicators (e.g., left ventricular ejection fraction, ischemic etiology, serum levels, New York Heart Association classification).	C	33
BNP is a predictor of death and cardiovascular events in persons without a previous cardiac dysfunction diagnosis.	C	33
It is premature to use BNP for treatment monitoring in patients with heart failure until further randomized controlled trials are completed.	C	32