In particular, adverse events were not consistently reported, with many results based on only one trial, resulting in particularly large confidence intervals around the estimates of effect for those data. Heart failure and chronic kidney disease: Subgroup analyses of patients with chronic kidney disease (CKD) were available from one primary study and one of the existing meta-analyses mentioned above. These analyses provided evidence for all-cause mortality (eight studies) and all-cause hospitalisation (one study). For the all-cause hospitalisation data, the committee noted that of the 2021 patients included in the existing meta-analyses for whom an eGFR was calculated, 57% had an eGFR of 60ml/min/1.73m2 and were therefore categorised as having CKD, so the subgroup was large and robust. All of the evidence was at serious or very serious risk of bias due to insufficient information about randomisation and/or allocation concealment, and insufficient information about the planning or categorisation of the CKD subgroup analyses. All of the evidence was also imprecise, with wide confidence intervals around the effect estimates, which reduced certainty in the results. The evidence for mortality was inconsistent due to the heterogeneity between effect estimates in those with HFREF and HFpEF. The hospitalisation evidence was also rated as indirect, as the reported data were number of days in hospital rather than the preferred measure of number of hospitalisation events or hospitalised patients. Heart failure and atrial fibrillation: No studies reported on the use of NP monitoring in patients with heart failure and atrial fibrillation (AF). Monitoring using other biomarkers or repeated cardiac imaging (echocardiography or cardiac MRI) No studies comparing usual care with monitoring with troponin or combinations of different biomarkers, repeated echocardiography, or cardiac Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. 