Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure

Maisel, Alan S.; Krishnaswamy, Padma; Nowak, Richard M.; McCord, James; Hollander, Judd E.; Duc, Philippe; Omland, Torbjørn; Storrow, Alan B.; Abraham, William T.; Wu, Alan H.B.; Clopton, Paul; Steg, Philippe Gabriel; Westheim, Arne; Knudsen, Catherine W.; Perez, Alberto; Kazanegra, Radmila; Herrmann, Howard C.; McCullough, Peter A.

doi:10.1056/nejmoa020233

Cited by 2,939 publications

(1,383 citation statements)

References 30 publications

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“…Like other natriuretic peptides, the serum concentration of NT-proBNP increases as a response to increased left ventricular myocardial wall stress 25,26. NT-proBNP levels increased in patients with disorders causing left ventricular diastolic dysfunction, but this increase in NT-proBNP was not as much as that seen in left ventricular systolic dysfunction 27…”

Section: Discussionmentioning

confidence: 99%

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

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AimThe aim of this study was to detect any relationship between serum high-sensitivity C-reactive protein (hs-CRP), serum amyloid-associated protein (SAA) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and reversible myocardial ischaemia during cardiovascular exercise tests and to determine whether these biomarkers could predict transient myocardial ischaemia.MethodsNinety-six patients (36 women, 60 men, mean age 57 ± 8.5 years) were included in the study. Venous blood samples were taken from patients before and 15 minutes after exercise testing. SAA and hs-CRP were analysed using immunonephelometric assays (Dade-Behring, BN II, Marburg, Germany). NT-proBNP (pg/ml) was determined using the immulite 1 000 chemiluminescence immunoassay system (Siemens Medical Solution Diagnostics, Deerfiled, USA). Forty-eight patients (18 women, 30 men) with positive exercise tests were allocated to the exercise-positive group and 48 (18 women, 30 men) with negative exercise tests were put in the exercise-negative group. Coronary angiography was performed on all patients in the exercise-positive group.ResultsThere was no difference between the levels of hs-CRP, SAA and NT-pro-BNP before and after exercise testing in both of the exercise groups.ConclusionSerum levels of hs-CRP, SAA and NT-proBNP could not predict the occurrence of reversible myocardial ischaemia during exercise. Large-scale clinical studies are needed to clarify the status of hs-CRP, SAA and NT-proBNP with exercise.

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Section: Discussionmentioning

confidence: 99%

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

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“…The use of NPs in the ED for diagnostic purposes has been studied extensively with concordant results 2, 12, 13, 14. Nevertheless, no studies were able to provide strong evidence that this has a beneficial impact on outcome.…”

Section: Discussionmentioning

confidence: 99%

Early identification of acute heart failure at the time of presentation: do natriuretic peptides make the difference?

et al. 2018

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BackgroundThe early identification of patients with acute heart failure (AHF) is challenging as many other diseases lead to a clinical presentation with dyspnea.AimThe aim of the study was to evaluate the impact of natriuretic peptides at common HF study cut‐offs on the diagnosis of patients with dyspnea at admission.Methods and resultsFor this post hoc analysis, we analysed n = 726 European Union (EU) patients from the prospective BACH (Biomarkers in Acute Heart Failure) study. Cut‐offs were 350 ng/L (BNP), 300 pmol/L [pro‐atrial natriuretic peptide (proANP)], and 1800 ng/L (NT‐proBNP). These cut‐offs had equivalent 90 days' mortality in the EU cohort of BACH. We analysed the effect of selection using these cut‐offs on the prevalence of the gold standard diagnoses made in the BACH study and the respective mortality. The prevalence of AHF is increased from 47.5 to 75.6% (NT‐proBNP criteria) up to 79.7% (BNP criteria). With the use of the proANP criteria, 90 days' mortality of patients with AHF rose from 14 to 17% (P = 0.029). In the group with no‐AHF diagnoses, mortality rose from 10 to 25% (P < 0.001).ConclusionsThe prevalence of patients with the gold standard diagnoses of AHF among those presenting with dyspnea to the emergency department is significantly increased by the use of natriuretic peptides with common cut‐offs used in prospective HF studies. Nevertheless, in the selected groups, patients with no AHF diagnosis have the highest mortality, and therefore, the addition of a natriuretic peptide alone is insufficient to start specific therapies.

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“…59 This trial enrolled 1,586 consecutive patients presenting with shortness of breath in the emergency rooms of seven centers worldwide. Over one-third had a history of myocardial infarction and CHF, and over 40% had a history of obstructive pulmonary disease.…”

Section: Diagnosis Of Chronic Heart Failurementioning

confidence: 99%

“…The effectiveness of BNP measurement in the assessment of emergency room patients with CHF complaints has already been discussed. 13,59,72 The application of these results to the outpatient setting and on hospital wards has yet to be established.…”

Section: The Role Of B-type Natriuretic Peptide Measurement In Chronimentioning

confidence: 99%

B‐type natriuretic peptide measurement in heart failure

Spevack

Schwartzbard

2004

Clinical Cardiology

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SummarySerum testing for the hormone B-type natriuretic peptide (BNP) may have clinical utility in congestive heart failure (CHF). This hormone is secreted predominantly by the left ventricular myocardium in patients with CHF. Measurement of serum BNP may improve diagnosis of CHF and may also help guide therapy in patients with CHF. The literature regarding the clinical utility of BNP measurement in CHF is reviewed.

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Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure

Abstract: Used in conjunction with other clinical information, rapid measurement of B-type natriuretic peptide is useful in establishing or excluding the diagnosis of congestive heart failure in patients with acute dyspnea.

Cited by 2,939 publications

References 30 publications

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Early identification of acute heart failure at the time of presentation: do natriuretic peptides make the difference?

B‐type natriuretic peptide measurement in heart failure

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