Diagnostic value of N-terminal ProB-Type Natriuretic Peptide in Emergency Department: Analysis by subgroups

Emergency Care Journal. 2012;8(3):34-38 DOI 10.4081/ecj.2012.3.34

 

Journal Homepage

Journal Title: Emergency Care Journal

ISSN: 1826-9826 (Print); 2282-2054 (Online)

Publisher: PAGEPress Publications

Society/Institution: Academy of Emergency Medicine and Care

LCC Subject Category: Medicine: Medicine (General)

Country of publisher: Italy

Language of fulltext: Italian, English

Full-text formats available: PDF, XML

 

AUTHORS

P. Villa (Medicine I, Emergency Department, Luigi Sacco Hospital)
A. Dolci (Clinical Biochemistry Laboratory, Luigi Sacco Hospital)
R. Dominici (Clinical Biochemistry Laboratory, Luigi Sacco Hospital)
M. Panteghini (Department of Clinical Sciences, University of Milan, Milan)
C. Fundarò (Medicine I, Emergency Department, Luigi Sacco Hospital)
S. Guzzetti (Medicine I, Emergency Department, Luigi Sacco Hospital)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 10 weeks

 

Abstract | Full Text

Objectives. Our aim was to evaluate the diagnostic impact of N-terminal pro B-type natriuretic peptide (NT-proBNP) measurement in patients presenting with acute dyspnea in Emergency Department (ED), taking into account clinical and chest x-ray results routinely obtained. Methods. This was a prospective observational study. Four hundred eighty-eight consecutive subjects evaluated for dyspnea in a metropolitan 600 beds hospital ED, entered into the final data analysis. According to a clinical and radiological score, the patients enrolled were divided in three groups: low (A-group), intermediate (B-group), and high (C-group) probability of heart failure. Results. NT-proBNP median value was 2445 ng/L (Inter Quartile Range 631-5847 ng/L), and the area under the receiver-operating characteristic curves (AUC) was 0.854 for NT-proBNP, 0.921 for clinical/radiological score and 0.936 for the two in combination (logistic model). In the B-group (intermediate) NT-proBNP test added correct diagnostic information in 126 subjects with HF and in 53 subjects without a final diagnosis of HF. In A- and C-group NT-proBNP test added correct diagnostic information in 1 patient. Conclusions. NT-proBNP did not substantially enhance diagnostic accuracy in all patients with shortness of breath in ED. However, in patients with not conclusive clinical and radiological results NT-proBNP determinations improved the percentage of correct diagnosis.