Document Detail


Value of brain natriuretic peptides in primary care patients with the clinical diagnosis of chronic heart failure.
MedLine Citation:
PMID:  19247872     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Brain natriuretic peptide (BNP) and N-Terminal pro natriuretic peptide (NT-proBNP) are widely accepted to diagnose congestive heart failure (CHF) in the emergency room. The aim of this study was to evaluate the value of BNP and NT-proBNP to diagnose CHF in primary care. METHODS: Clinical and Doppler-echocardiographic assessment of patients referred by their general practitioner (GP) with the diagnosis of CHF. Receiver operating curves were used to evaluate the accuracy of BNP and NT-proBNP for echocardiographically confirmed systolic and/or diastolic heart failure. RESULTS: Three hundred and eighty four patients (mean age of 65) were included. One hundred and ninety three (50%) patients had systolic heart failure and 31 (8%) had isolated diastolic heart failure. Using currently recommended cut-off values of BNP (less than 100 pg/ml) and NT-proBNP (less than 125 pg/ml) for exclusion of CHF, BNP was false negative in 25% and NT-proBNP in 10% of the patients. The area under the curve was better for NT-proBNP than for BNP (0.742 vs. 0.691). CONCLUSION: In this population with a high prevalence of CHF, BNP and NT-proBNP failed to adequately rule out CHF. GP's should be cautious when using BNP and NT-proBNP in primary care. An echocardiography remains compulsory in unexplained dyspnea.
Authors:
Michel Zuber; Florim Cuculi; Christine H Attenhofer Jost; Peter Kipfer; Peter Buser; Burkhardt Seifert; Paul Erne
Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  43     ISSN:  1651-2006     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2009  
Date Detail:
Created Date:  2010-06-23     Completed Date:  2010-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  324-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kantonsspital Luzern, Luzern, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Cardiovascular Agents / therapeutic use
Chronic Disease
Dyspnea / blood,  etiology
Echocardiography, Doppler
Female
Heart Failure, Diastolic / blood*,  complications,  drug therapy,  ultrasonography
Heart Failure, Systolic / blood*,  complications,  drug therapy,  ultrasonography
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Primary Health Care*
Prospective Studies
ROC Curve
Referral and Consultation
Switzerland
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cardiovascular Agents; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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