BACKGROUND: It is often difficult to diagnose heart failure (HF) accurately in patients presenting with dyspnea to the emergency department (ED). This study assessed whether B-type natriuretic peptide (BNP) testing in these patients improved the accuracy of HF diagnosis. METHODS AND RESULTS:Patients presenting to the Alfred and the Northern Hospital EDs with a chief complaint of dyspnea were enrolled prospectively from August 2005 to April 2007. Patients were randomly allocated to have BNP levels tested or not. The diagnostic gold standard for HF was determined by 1 cardiologist and 1 emergency or respiratory physician who, blinded to the BNP result, independently reviewed all available information. The ED diagnosis of HF in the non-BNP group showed a sensitivity, specificity, and accuracy of 65%, 92%, and 81%, respectively. The BNP group had a similar sensitivity, specificity, and accuracy of 66%, 90%, and 78%, respectively, for the diagnosis of HF in the ED. There was no significant difference between the BNP and non-BNP groups in any of the measures of diagnostic accuracy for HF. CONCLUSIONS: In the clinical setting of EDs, availability of BNP levels did not significantly improve the accuracy of a diagnosis of HF. Clinical Trial Registration- clinicaltrials.gov. Identifier: NCT00163709.
RCT Entities:
BACKGROUND: It is often difficult to diagnose heart failure (HF) accurately in patients presenting with dyspnea to the emergency department (ED). This study assessed whether B-type natriuretic peptide (BNP) testing in these patients improved the accuracy of HF diagnosis. METHODS AND RESULTS:Patients presenting to the Alfred and the Northern Hospital EDs with a chief complaint of dyspnea were enrolled prospectively from August 2005 to April 2007. Patients were randomly allocated to have BNP levels tested or not. The diagnostic gold standard for HF was determined by 1 cardiologist and 1 emergency or respiratory physician who, blinded to the BNP result, independently reviewed all available information. The ED diagnosis of HF in the non-BNP group showed a sensitivity, specificity, and accuracy of 65%, 92%, and 81%, respectively. The BNP group had a similar sensitivity, specificity, and accuracy of 66%, 90%, and 78%, respectively, for the diagnosis of HF in the ED. There was no significant difference between the BNP and non-BNP groups in any of the measures of diagnostic accuracy for HF. CONCLUSIONS: In the clinical setting of EDs, availability of BNP levels did not significantly improve the accuracy of a diagnosis of HF. Clinical Trial Registration- clinicaltrials.gov. Identifier: NCT00163709.
Authors: Stephen A Hill; Ronald A Booth; P Lina Santaguida; Andrew Don-Wauchope; Judy A Brown; Mark Oremus; Usman Ali; Amy Bustamam; Nazmul Sohel; Robert McKelvie; Cynthia Balion; Parminder Raina Journal: Heart Fail Rev Date: 2014-08 Impact factor: 4.214
Authors: Emmert Roberts; Andrew J Ludman; Katharina Dworzynski; Abdallah Al-Mohammad; Martin R Cowie; John J V McMurray; Jonathan Mant Journal: BMJ Date: 2015-03-04
Authors: Nathalie Brunkhorst-Kanaan; Moritz Verdenhalven; Sarah Kittel-Schneider; Isabella Vainieri; Andreas Reif; Oliver Grimm Journal: Front Psychiatry Date: 2020-03-20 Impact factor: 4.157
Authors: Julian T Hertz; Francis M Sakita; Alexander T Limkakeng; Blandina T Mmbaga; Lambert T Appiah; John A Bartlett; Sophie W Galson Journal: Afr J Emerg Med Date: 2019-08-08