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

  • P. Villa | lucia.zoppi@pagepress.org Medicine I, Emergency Department, Luigi Sacco Hospital, Italy.
  • A. Dolci Clinical Biochemistry Laboratory, Luigi Sacco Hospital, Italy.
  • R. Dominici Clinical Biochemistry Laboratory, Luigi Sacco Hospital, Italy.
  • M. Panteghini Department of Clinical Sciences, University of Milan, Milan, Italy.
  • C. Fundarò Medicine I, Emergency Department, Luigi Sacco Hospital, Italy.
  • S. Guzzetti Medicine I, Emergency Department, Luigi Sacco Hospital, Italy.

Abstract

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.

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Published
2012-12-13
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Section
Clinics and Therapy
Keywords:
vN-terminal ProB-Type Natriuretic Peptide, dyspnea, heart failure, diagnosis
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How to Cite
Villa, P., Dolci, A., Dominici, R., Panteghini, M., Fundarò, C., & Guzzetti, S. (2012). Diagnostic value of N-terminal ProB-Type Natriuretic Peptide in Emergency Department: Analysis by subgroups. Emergency Care Journal, 8(3), 34-38. https://doi.org/10.4081/ecj.2012.3.34