Document Detail

Predictors of elevated B-type natriuretic peptide concentrations in dyspneic patients without heart failure: an analysis from the breathing not properly multinational study.
MedLine Citation:
PMID:  15940086     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: B-type natriuretic peptide (BNP) is an established tool for the diagnosis of acute congestive heart failure in patients presenting with dyspnea. Some patients have moderately elevated BNP levels (ie, 100 to 500 pg/mL) in the absence of acute congestive heart failure. The objective of the current study was to identify independent predictors of elevated BNP concentrations in the absence of congestive heart failure. METHODS: We studied 781 patients without acute congestive heart failure and BNP levels 0 to 500 pg/mL drawn from a cohort of 1,586 patients with acute dyspnea who had BNP levels measured on emergency department arrival. Two cardiologists blinded to BNP results reviewed all clinical data and categorized patients according to whether they had acute congestive heart failure or not. RESULTS: Independent predictors of elevated BNP levels (ie, >100 pg/mL) were a medical history of atrial fibrillation, radiographic cardiomegaly, decreased blood hemoglobin concentration, decreased body mass index, and increased age. CONCLUSION: Knowledge of these commonly obtained variables should aid clinicians in the interpretation of moderately elevated BNP results in patients presenting with acute dyspnea in the emergency department.
Cathrine W Knudsen; Paul Clopton; Arne Westheim; Tor Ole Klemsdal; Alan H B Wu; Philippe Duc; James McCord; Richard M Nowak; Judd E Hollander; Alan B Storrow; William T Abraham; Peter A McCullough; Alan S Maisel; Torbjørn Omland
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  45     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-07     Completed Date:  2006-05-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  573-80     Citation Subset:  AIM; IM    
University of California, San Diego, Veteran's Affairs Medical Center, San Diego, CA, USA.
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MeSH Terms
Arrhythmias, Cardiac / epidemiology
Biological Markers / blood
Chronic Disease
Dyspnea / blood*,  epidemiology*
Heart Failure / diagnosis*,  epidemiology
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood*
Predictive Value of Tests
Pulmonary Embolism / epidemiology
Respiration Disorders / epidemiology
Retrospective Studies
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain
Comment In:
Ann Emerg Med. 2006 Feb;47(2):213-4; author reply 214   [PMID:  16431242 ]

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