BACKGROUND: Measurement of B type natriuretic peptide and its N terminal prohormone (NTproBNP) can now be performed routinely by automated high-throughput immunoassays. The study compared measurement of NTproBNP with measurement of N terminal pro-atrial natriuretic peptide (NTproANP) for detection of ventricular systolic dysfunction in primary care. METHODS: 734 subjects aged >45 years (349 men and 385 women, median age 58 years, range 45-89, interquartile range 51-67 years) from seven representative general practices attended for echocardiography with determination of ejection fraction and completed a questionnaire. Blood samples were collected into gel serum separation tubes (Becton-Dickinson, Franklin Lakes, New Jersey, USA), the serum separated and aliquots stored frozen at -70 degrees C until analyses. Samples were analysed for NTproBNP (Roche Diagnostics, Lewes, UK; coefficient of variation (CV) 3.2-2.4%) and for NTproANP (Biomedica, Vienna, Austria; CV 5.6-10.1%). Echocardiography was used as the diagnostic "gold standard", with ventricular systolic dysfunction defined as abnormal when there was an ejection fraction of <or=40%. Patients were dichotomised by ejection fraction from 50% to 30%, and receiver operating characteristic curves constructed and the area under the curve (AUC) compared. RESULTS: At 40% ejection fraction, NTproANP and NTproBNP showed AUCs of, respectively, 0.738 (0.601-0.875) and 0.973 (0.958-0.989), p<0.004. CONCLUSION: NTproBNP is superior to NTproANP for detection of systolic dysfunction.
BACKGROUND: Measurement of B type natriuretic peptide and its N terminal prohormone (NTproBNP) can now be performed routinely by automated high-throughput immunoassays. The study compared measurement of NTproBNP with measurement of N terminal pro-atrial natriuretic peptide (NTproANP) for detection of ventricular systolic dysfunction in primary care. METHODS: 734 subjects aged >45 years (349 men and 385 women, median age 58 years, range 45-89, interquartile range 51-67 years) from seven representative general practices attended for echocardiography with determination of ejection fraction and completed a questionnaire. Blood samples were collected into gel serum separation tubes (Becton-Dickinson, Franklin Lakes, New Jersey, USA), the serum separated and aliquots stored frozen at -70 degrees C until analyses. Samples were analysed for NTproBNP (Roche Diagnostics, Lewes, UK; coefficient of variation (CV) 3.2-2.4%) and for NTproANP (Biomedica, Vienna, Austria; CV 5.6-10.1%). Echocardiography was used as the diagnostic "gold standard", with ventricular systolic dysfunction defined as abnormal when there was an ejection fraction of <or=40%. Patients were dichotomised by ejection fraction from 50% to 30%, and receiver operating characteristic curves constructed and the area under the curve (AUC) compared. RESULTS: At 40% ejection fraction, NTproANP and NTproBNP showed AUCs of, respectively, 0.738 (0.601-0.875) and 0.973 (0.958-0.989), p<0.004. CONCLUSION: NTproBNP is superior to NTproANP for detection of systolic dysfunction.
Authors: T A McDonagh; S D Robb; D R Murdoch; J J Morton; I Ford; C E Morrison; H Tunstall-Pedoe; J J McMurray; H J Dargie Journal: Lancet Date: 1998-01-03 Impact factor: 79.321
Authors: Karen Sliwa; Dike Ojji; Katrin Bachelier; Michael Böhm; Albertino Damasceno; Simon Stewart Journal: Clin Res Cardiol Date: 2014-01-28 Impact factor: 5.460