Accuracy of N-terminal-pro-atrial natriuretic peptide in patients admitted to emergency department.

Autor: Gruson D; Diabetes and Nutrition Unit, Cliniques Universitaires St-Luc, Brussels, Belgium. gruson_damien@yahoo.fr, Rousseau MF, Ahn S, Van Linden F, Thys F, Ketelslegers JM, Verschuren F
Jazyk: angličtina
Zdroj: Scandinavian journal of clinical and laboratory investigation [Scand J Clin Lab Invest] 2008; Vol. 68 (5), pp. 410-4.
DOI: 10.1080/00365510701810605
Abstrakt: Objective: B-type natriuretic peptide (BNP) and N-terminal-pro-BNP (Nt-proBNP) are commonly used for the triage of patients in the emergency department (ED) with dyspnoea and/or chest pain. The aim of our study was to determine the accuracy of N-terminal-pro-ANP (Nt-proANP) in such patients.
Material and Methods: Nt-proANP was measured by home-made radioimmunoassay in 137 ED patients admitted with cardiovascular and/or pulmonary disorders. BNP and Nt-pro-BNP were determined with automated assays. Final diagnosis was confirmed at discharge or after follow-up.
Results: Nt-proANP levels were significantly influenced by the diagnostic subgroups (ANOVA: p<0.001) and were [geometric mean (range)]: 19727 ng/L (5260-45200) in congestive heart failure (CHF, n=31), 6575 ng/L (1350-36000) in coronary artery disease (CAD, n=19), 5324 ng/L (1710-13150) in pulmonary embolism (PE, n=20), 5035 ng/L (1510-16600) in pulmonary diseases (PD, n=24) and 3001 ng/L (750-11860) in patients without cardiopulmonary diseases (n=43). Pairwise comparisons demonstrated that CHF patients had Nt-pro-ANP values higher than all other groups (p<0.05) and that patients without cardiopulmonary diseases had the lowest values (p<0.05). For diagnosis of CHF, the area under the ROC curve of Nt-proANP was 0.94 (95 % CI: 0.89-0.98) and was equivalent to Nt-proBNP (0.91; p=0.284) and BNP (0.93; p=0.572).
Conclusions: The diagnostic accuracy of Nt-proANP was equivalent to BNP and Nt-proBNP in the present cohort of patients admitted to ED with dyspnoea and/or chest pain.
Databáze: MEDLINE
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