Hospitalisations and hyperkalaemia suggested a clinically important increase with NP monitoring (all associated with wide Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 confidence intervals around the effect estimate). For the outcomes acute kidney injury and bradycardia (n=289) low to very low quality evidence was found which suggested no clinical effect of NP monitoring. Mortality did not demonstrate a clear effect with the confidence interval ranging from a decrease and increase in all-cause mortality. NP monitoring versus no monitoring protocol All ages: High quality evidence was found for the outcome mortality (n=182), and moderate quality evidence for HF hospitalisations (n=182) both of which suggested a clinically important reduction in deaths with NP monitoring. Age <75 years: Moderate to very low quality evidence was found for the outcome mortality reported as a hazard ratio (n=70) and a risk ratio (n=122) both of which suggested a clinically important reduction in the number of deaths with NP monitoring. Very low quality evidence was found for the outcomes all- cause hospitalisation (n=50) and HF hospitalisation (n=122). For the outcome all-cause hospitalisation there was a clinically important increase with NP monitoring. However for HF hospitalisations the evidence suggested a clinically important reduction with NP monitoring. Age 75 years: Moderate to very low quality evidence was found for the outcomes mortality reported as a hazard ratio (n=50) and a risk ratio (n=121) both of which did not demonstrate a clear effect with the confidence interval ranging from a decrease and increase in all-cause mortality.Very low quality evidence was also found for the outcomes all-cause hospitalisation (n=70) and HF hospitalisation (n=121) both of which suggested a clinically important increase with NP monitoring No relevant studies comparing usual care with troponin or combinations of different biomarkers were identified. 