BACKGROUND: Brain natriuretic peptide (BNP) may help general practitioners (GPs) to "rule-out" heart failure (HF) and reduce referral burden on specialist assessment clinics. AIMS: To determine the diagnostic value of BNP in HF referrals by GPs to a specialist unit. METHODS: From 2003 to 2007, 327 GP referrals were made to a HF new patient diagnostic clinic (NDC) with a provisional diagnosis of HF. The NDC provides rapid assessment of potential HF patients and ensures appropriate therapy and follow-up for those with a confirmed diagnosis. HF diagnosis was confirmed by the Framingham criteria. RESULTS: HF was present in 39% of cases referred (mean age 75 +/- 10 years, 49% male). The inclusion of BNP as a "rule-out" test with a cut-off value of 100 pg/mL would have reduced the number of patients originally referred to the NDC by 175. However, this would have resulted in delayed diagnosis and treatment of 20 (16%) "false-negative" patients. CONCLUSIONS: Availability of BNP to GPs would improve referral patterns but with high risk of delayed diagnosis. The data underline the need for a shared-care approach to the new diagnosis of HF.
BACKGROUND:Brain natriuretic peptide (BNP) may help general practitioners (GPs) to "rule-out" heart failure (HF) and reduce referral burden on specialist assessment clinics. AIMS: To determine the diagnostic value of BNP in HF referrals by GPs to a specialist unit. METHODS: From 2003 to 2007, 327 GP referrals were made to a HF new patient diagnostic clinic (NDC) with a provisional diagnosis of HF. The NDC provides rapid assessment of potential HF patients and ensures appropriate therapy and follow-up for those with a confirmed diagnosis. HF diagnosis was confirmed by the Framingham criteria. RESULTS: HF was present in 39% of cases referred (mean age 75 +/- 10 years, 49% male). The inclusion of BNP as a "rule-out" test with a cut-off value of 100 pg/mL would have reduced the number of patients originally referred to the NDC by 175. However, this would have resulted in delayed diagnosis and treatment of 20 (16%) "false-negative" patients. CONCLUSIONS: Availability of BNP to GPs would improve referral patterns but with high risk of delayed diagnosis. The data underline the need for a shared-care approach to the new diagnosis of HF.
Authors: Alex Zaphiriou; Stephen Robb; Tarita Murray-Thomas; Gustavo Mendez; Kevin Fox; Theresa McDonagh; Suzanna M C Hardman; Henry J Dargie; Martin R Cowie Journal: Eur J Heart Fail Date: 2005-06 Impact factor: 15.534
Authors: Rory O'Hanlon; Paula O'Shea; Mark Ledwidge; Christina O'Loughlin; Sophie Lange; Carmel Conlon; Dermot Phelan; Sean Cunningham; Ken McDonald Journal: J Card Fail Date: 2007-02 Impact factor: 5.712
Authors: Dunya Atisha; Meenakshi A Bhalla; L Katherine Morrison; Leda Felicio; Paul Clopton; Nancy Gardetto; Radmila Kazanegra; Albert Chiu; Alan S Maisel Journal: Am Heart J Date: 2004-09 Impact factor: 4.749
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