Chris Watson1,2, Stephanie James2, Eoin O'Connell2, Joe Gallagher2, James O'Reilly3, Elaine Tallon2, John Baugh3, Jean O'Connell4, Donal O'Shea4, Mark Ledwidge2, Ken McDonald2,3. 1. a Wellcome-Wolfson Building, Centre for Experimental Medicine , Queen's University Belfast , Belfast , Northern Ireland ; 2. b Chronic Cardiovascular Disease Management Group , St Vincent's University Hospital Healthcare Group , Dublin , Ireland ; 3. c School of Medicine , University College Dublin , Belfield, Dublin , Ireland ; 4. d Department of Endocrinology , St Vincent's University Hospital Healthcare Group , Elm Park, Dublin , Ireland.
Abstract
CONTEXT: Natriuretic peptide (NP) has been shown to be an effective screening tool to identify patients with Stage B heart failure and to have clinical value in preventing heart failure progression. The impact of associated metabolic confounders on the screening utility of NP needs clarification. OBJECTIVE: To assess the impact of diabetes mellitus (DM) on NP screening for asymptomatic Stage B heart failure. MATERIALS AND METHODS: The study population consisted of 1368 asymptomatic patients with cardiovascular risk factors recruited from general practice as part of the STOP-HF trial. B-type NP (BNP) was quantified at point-of-care. RESULTS: BNP was found to be as accurate for detecting Stage B heart failure in DM patients compared to non-DM patients (AUC 0.75 [0.71,0.78] and 0.77 [0.72,0.82], respectively). However, different BNP thresholds are required to achieve the same level of diagnostic sensitivity in DM compared with non-DM patients. To achieve 80% sensitivity a difference of 5-ng/L lower is required for patients with DM. CONCLUSION: Although a significantly different BNP threshold is detected for patients with DM, the BNP concentration difference is small and unlikely to warrant a clinically different diagnostic threshold.
CONTEXT: Natriuretic peptide (NP) has been shown to be an effective screening tool to identify patients with Stage B heart failure and to have clinical value in preventing heart failure progression. The impact of associated metabolic confounders on the screening utility of NP needs clarification. OBJECTIVE: To assess the impact of diabetes mellitus (DM) on NP screening for asymptomatic Stage B heart failure. MATERIALS AND METHODS: The study population consisted of 1368 asymptomatic patients with cardiovascular risk factors recruited from general practice as part of the STOP-HF trial. B-type NP (BNP) was quantified at point-of-care. RESULTS:BNP was found to be as accurate for detecting Stage B heart failure in DMpatients compared to non-DMpatients (AUC 0.75 [0.71,0.78] and 0.77 [0.72,0.82], respectively). However, different BNP thresholds are required to achieve the same level of diagnostic sensitivity in DM compared with non-DMpatients. To achieve 80% sensitivity a difference of 5-ng/L lower is required for patients with DM. CONCLUSION: Although a significantly different BNP threshold is detected for patients with DM, the BNP concentration difference is small and unlikely to warrant a clinically different diagnostic threshold.
Authors: Kathryn S Taylor; Jan Y Verbakel; Benjamin G Feakins; Christopher P Price; Rafael Perera; Clare Bankhead; Annette Plüddemann Journal: BMJ Date: 2018-05-21
Authors: Chris J Watson; Isaac Tea; Eoin O'Connell; Nadezhda Glezeva; Shuaiwei Zhou; Stephanie James; Joe Gallagher; James Snider; James L Januzzi; Mark T Ledwidge; Ken M McDonald Journal: J Cell Mol Med Date: 2020-04-29 Impact factor: 5.310
Authors: Andrzej S Januszewski; Chris J Watson; Vikki O'Neill; Kenneth McDonald; Mark Ledwidge; Tracy Robson; Alicia J Jenkins; Anthony C Keech; Lana McClements Journal: Sci Rep Date: 2020-12-10 Impact factor: 4.379