Routine use of natriuretic peptides: Lessons from a big data analysis.
| Autor: | Goudot FX; Cardiology Department, Avicenne University Hospital, APHP, Université Sorbonne Paris Nord, Bobigny, France., Msadek S; Cardiology Department, Avicenne University Hospital, APHP, Université Sorbonne Paris Nord, Bobigny, France., Boukertouta T; Cardiology Department, Avicenne University Hospital, APHP, Université Sorbonne Paris Nord, Bobigny, France., Schischmanoff PO; Biochemistry Department, Avicenne University Hospital, APHP, Université Sorbonne Paris Nord, Bobigny, France., Meune C; Cardiology Department, Avicenne University Hospital, APHP, Université Sorbonne Paris Nord, Bobigny, France. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of clinical biochemistry [Ann Clin Biochem] 2021 Sep; Vol. 58 (5), pp. 481-486. Date of Electronic Publication: 2021 Jun 02. |
| DOI: | 10.1177/00045632211020779 |
| Abstrakt: | Background: Natriuretic peptides have broad indications during heart failure and the detection of left ventricular dysfunction in high-risk patients. They can also be used for the diagnosis/management of other cardiac diseases. However, very little is known regarding their use in routine practice. Methods: We examined all biological tests performed from February 2010 to August 2015 in two districts from the French Brittany, covering 13,653 km 2 and including 22,265 physicians. We report the settings and conditions of N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements (the only locally natriuretic peptide available). Results: From a total of 3,606,432 tests requested in 557,650 adult (older than 20 years) patients, only 56,653 (1.6%) included at least one NT-proBNP measurement. NT-proBNP measurements gradually increased, from 9188 in 2011 to 12,938 in 2014 ( P < 0.001). Most NT-proBNP tests were measured in urban laboratories (72.7%) and in private (62.9%) non-hospital/clinics laboratories; they were mostly ordered by general practitioners (66% compared with 11% by cardiologists). The number of NT-proBNP measurements increased with age up to 80-90 years, and 70.3% of tests were measured in ≥75 years patients. Creatinine and electrolytes were not associated with NT-proBNP in 15.8% and 19.7% of tests, respectively. Conclusion: Among a very large cohort, we observed that natriuretic peptides remain largely undermeasured. NT-proBNP is mostly measured in elderly patients, and its interpretation may be hazardous in up to 16% of all individuals because no measurement of creatinine was associated to NT-proBNP. |
| Databáze: | MEDLINE |
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