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. No relevant studies comparing usual care with routine cardiac imaging were identified. Economic One cost utility analysis found that: o in patients with CHF and LVSD specialist natriuretic peptide monitoring was cost effective compared to specialist clinical assessment (ICER: 3,304 per QALY gained). in patients under the age of 75 with CHF and LVSD specialist natriuretic peptide monitoring was cost effective compared to specialist clinical assessment (ICER: 2,871 per QALY gained). in patients over the age of 75 with CHF and LVSD specialist natriuretic peptide monitoring was cost effective compared to specialist clinical assessment (ICER: 5,392 per QALY gained). o in patients with CHF of any cause specialist natriuretic peptide monitoring was cost effective compared to specialist clinical assessment and usual care in the community (ICER: 14,694 per QALY gained compared to specialist clinical assessment). in patients under the age of 75 with CHF of any cause specialist natriuretic peptide monitoring was cost effective compared to specialist clinical assessment and usual care in the community (ICER: 2,517 per QALY gained compared to usual care in the community). Specialist clinical assessment was extendedly dominated. Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. 