OBJECTIVES: To determine the screening and diagnostic properties of BNP and NT-proBNP for heart failure in primary care. DESIGN AND METHODS: We conducted a systematic review of randomized control trials and observational (cohort or case-control) studies of heart failure detection using B-type natriuretic peptides published in English from January 1989 to February 2005. We extracted or calculated sensitivity, specificity, positive and negative likelihood ratios, area under the receiver-operator characteristic curve and diagnostic odds ratio (DOR). RESULTS: We included 17 studies (7 screening, 9 diagnosis in primary care or specialised clinic, 1 both). There was considerable heterogeneity within the study populations, reference standard for diagnosis, and B-type natriuretic peptide decision point. Sensitivity ranged from 26% to 98%; and specificity from 44% to 88%. For screening, the Diagnostic Odds Ratio (DOR) ranged from 2.7 to 29, and for diagnosis from 2.8 to 137. CONCLUSIONS: The performance characteristics of B-type natriuretic peptides measurement are not suitable for screening asymptomatic patients. For diagnosis in primary care, low B-type natriuretic peptide values may be used to rule-out heart failure but, due to poor specificity, high values cannot be used to rule-in the condition.
OBJECTIVES: To determine the screening and diagnostic properties of BNP and NT-proBNP for heart failure in primary care. DESIGN AND METHODS: We conducted a systematic review of randomized control trials and observational (cohort or case-control) studies of heart failure detection using B-type natriuretic peptides published in English from January 1989 to February 2005. We extracted or calculated sensitivity, specificity, positive and negative likelihood ratios, area under the receiver-operator characteristic curve and diagnostic odds ratio (DOR). RESULTS: We included 17 studies (7 screening, 9 diagnosis in primary care or specialised clinic, 1 both). There was considerable heterogeneity within the study populations, reference standard for diagnosis, and B-type natriuretic peptide decision point. Sensitivity ranged from 26% to 98%; and specificity from 44% to 88%. For screening, the Diagnostic Odds Ratio (DOR) ranged from 2.7 to 29, and for diagnosis from 2.8 to 137. CONCLUSIONS: The performance characteristics of B-type natriuretic peptides measurement are not suitable for screening asymptomatic patients. For diagnosis in primary care, low B-type natriuretic peptide values may be used to rule-out heart failure but, due to poor specificity, high values cannot be used to rule-in the condition.
Authors: Shahram Shahangian; Todd D Alspach; J Rex Astles; Ajay Yesupriya; William K Dettwyler Journal: Arch Pathol Lab Med Date: 2013-06-05 Impact factor: 5.534
Authors: Saro H Armenian; Melissa M Hudson; Renee L Mulder; Ming Hui Chen; Louis S Constine; Mary Dwyer; Paul C Nathan; Wim J E Tissing; Sadhna Shankar; Elske Sieswerda; Rod Skinner; Julia Steinberger; Elvira C van Dalen; Helena van der Pal; W Hamish Wallace; Gill Levitt; Leontien C M Kremer Journal: Lancet Oncol Date: 2015-03 Impact factor: 41.316
Authors: Vijay Nambi; Xiaoxi Liu; Lloyd E Chambless; James A de Lemos; Salim S Virani; Sunil Agarwal; Eric Boerwinkle; Ron C Hoogeveen; David Aguilar; Brad C Astor; Pothur R Srinivas; Anita Deswal; Thomas H Mosley; Josef Coresh; Aaron R Folsom; Gerardo Heiss; Christie M Ballantyne Journal: Clin Chem Date: 2013-09-13 Impact factor: 8.327