Background: Natriuretic peptides (NPs) have broad indications during heart failure (HF) and the detection of left ventricular dysfunction in high-risk patients. They can also be used for the diagnosis/management of other cardiac diseases. However, very little is known regarding their use in routine practice.

Methods: We examined all biological tests performed from February 2010 to August 2015 in two districts from the French Brittany, covering 13,653 km2 and including 22,265 physicians. We report the settings and conditions of N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) measurements (the only locally NP available).

Results: From a total of 3,606,432 tests requested in 557,650 adult (older than 20 years) patients, only 56,653 (1.6%) included at least one NT-proBNP measurement. NT-proBNP measurements gradually increased, from 9,188 in 2011 to 12,938 in 2014 (p<0.001). Most NT-proBNP tests were measured in urban laboratories (72.7%) and in private (62.9%) non-hospital/clinics laboratories, they were mostly ordered by general practitioners (66% compared with 11% by cardiologists). The number of NT-proBNP measurements increased with age up to 80-90 years, and 70.3% of tests were measured in ≥75y patients. Creatinine and electrolytes were not associated with NT-proBNP in 15.8% and 19.7% of tests, respectively.

Conclusion: Among a very large cohort, we observed that NPs remain largely undermeasured. NT-proBNP is mostly measured in elderly patients, and its interpretation may be hazardous in up to 16% of all individuals because no measurement of creatinine was associated to NT-proBNP.

背景：利钠肽 (NPs) 在心力衰竭 (HF) 和检测高危患者的左心室功能障碍期间具有广泛的适应症。它们还可用于其他心脏疾病的诊断/管理。然而，关于它们在日常实践中的使用知之甚少。

方法：我们检查了 2010 年 2 月至 2015 年 8 月在法国布列塔尼的两个地区进行的所有生物测试，覆盖 13,653 平方公里，包括 22,265 名医生。我们报告了 N 端前 B 型利钠肽 (NT-proBNP) 测量（唯一可用的本地 NP）的设置和条件。

结果：在 557,650 名成人（20 岁以上）患者中要求进行的总共 3,606,432 项测试中，只有 56,653 (1.6%) 项包括至少一项 NT-proBNP 测量。NT-proBNP 测量值逐渐增加，从 2011 年的 9,188 次增加到 2014 年的 12,938 次（p<0.001）。大多数 NT-proBNP 检测是在城市实验室 (72.7%) 和私人 (62.9%) 非医院/诊所实验室测量的，它们大多由全科医生订购（66% 与心脏病专家的 11% 相比）。NT-proBNP 测量的数量随着年龄的增长而增加，直至 80-90 岁，并且 70.3% 的测试是在 75 岁以上的患者中测量的。在 15.8% 和 19.7% 的测试中，肌酐和电解质与 NT-proBNP 无关。

结论：在一个非常大的队列中，我们观察到 NPs 在很大程度上仍然被低估。NT-proBNP 主要在老年患者中测量，其解释可能对高达 16% 的所有个体有害，因为肌酐的测量与 NT-proBNP 无关。