AIM: Evaluation of N-terminal pro-brain natriuretic peptide (NT-proBNP) to confirm or disprove heart failure in community patients complaining of dyspnoea. METHODS AND RESULTS: General practitioners referred 345 consecutive patients complaining of dyspnoea to our hospital-based clinic, where a diagnosis was established based on a combined programme for heart and lung diseases including echocardiography. The level of NT-proBNP in plasma was also measured. The mean (S.D.) concentration of NT-proBNP in patients with heart failure was significantly higher, 189 (270) pmol/l in patients with heart failure (n=81), than in patients with non-cardiac dyspnoea (n=264), 17 (38) pmol/l (P<0.001). In patients > or = 50 years NT-proBNP <11 pmol/l for men and <17 pmol/l for women excluded heart failure with a negative predictive value of 97% while the positive predictive value was 53%, the sensitivity 95% and the specificity 68%. Areas under receiver operator characteristic curves for men and women were 0.93 and 0.90, respectively. CONCLUSION: In a relevant setting of primary care patients complaining of dyspnoea, NT-proBNP seems promising for disproval of heart failure, and this test may reduce the need for echocardiographic screening with 50%. However, the discrimination levels of NT-proBNP found in this study may need prospective confirmation, before the test can be generally recommended.
AIM: Evaluation of N-terminal pro-brain natriuretic peptide (NT-proBNP) to confirm or disprove heart failure in community patients complaining of dyspnoea. METHODS AND RESULTS: General practitioners referred 345 consecutive patients complaining of dyspnoea to our hospital-based clinic, where a diagnosis was established based on a combined programme for heart and lung diseases including echocardiography. The level of NT-proBNP in plasma was also measured. The mean (S.D.) concentration of NT-proBNP in patients with heart failure was significantly higher, 189 (270) pmol/l in patients with heart failure (n=81), than in patients with non-cardiac dyspnoea (n=264), 17 (38) pmol/l (P<0.001). In patients > or = 50 years NT-proBNP <11 pmol/l for men and <17 pmol/l for women excluded heart failure with a negative predictive value of 97% while the positive predictive value was 53%, the sensitivity 95% and the specificity 68%. Areas under receiver operator characteristic curves for men and women were 0.93 and 0.90, respectively. CONCLUSION: In a relevant setting of primary care patients complaining of dyspnoea, NT-proBNP seems promising for disproval of heart failure, and this test may reduce the need for echocardiographic screening with 50%. However, the discrimination levels of NT-proBNP found in this study may need prospective confirmation, before the test can be generally recommended.
Authors: Clare Davenport; Elaine Yee Lan Cheng; Yip Tung Tony Kwok; Annie Hiu On Lai; Taka Wakabayashi; Chris Hyde; Martin Connock Journal: Br J Gen Pract Date: 2006-01 Impact factor: 5.386
Authors: R Sharma; D C Gaze; D Pellerin; R L Mehta; H Gregson; C P Streather; P O Collinson; S J D Brecker Journal: Heart Date: 2005-10-10 Impact factor: 5.994
Authors: John Gierula; Richard M Cubbon; Maria F Paton; Rowenna Byrom; Judith E Lowry; Sarah F Winsor; Melanie McGinlay; Emma Sunley; Emma Pickles; Lorraine C Kearney; Aaron Koshy; Thomas A Slater; Hemant K Chumun; Haqeel A Jamil; Kristian M Bailey; Julian H Barth; Mark T Kearney; Klaus K Witte Journal: Eur Heart J Qual Care Clin Outcomes Date: 2019-07-01
Authors: Ronald A Booth; Stephen A Hill; Andrew Don-Wauchope; P Lina Santaguida; Mark Oremus; Robert McKelvie; Cynthia Balion; Judy A Brown; Usman Ali; Amy Bustamam; Nazmul Sohel; Parminder Raina Journal: Heart Fail Rev Date: 2014-08 Impact factor: 4.214