N-Terminal Pro–B-Type Natriuretic Peptide in the Emergency Department
| Autor: | Phillip D. Levy, W. Franklin Peacock, Judd E. Hollander, Richard M. Nowak, Gheorghe Doros, Annabel Angela Chen-Tournoux, Peter S. Pang, Icon-Reloaded Investigators, James L. Januzzi, E. Joy Rivers, John T. Nagurney, Elizabeth L. Walters, Darshita Patel, Hanna K. Gaggin, Robert H. Christenson |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class business.industry Emergency department 030204 cardiovascular system & hematology medicine.disease Predictive value Confidence interval 03 medical and health sciences 0302 clinical medicine Internal medicine Heart failure medicine Natriuretic peptide Cardiology Biomarker (medicine) In patient 030212 general & internal medicine N terminal pro b type natriuretic peptide Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 71:1191-1200 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2018.01.021 |
| Popis: | Background Contemporary reconsideration of diagnostic N-terminal pro–B-type natriuretic peptide (NT-proBNP) cutoffs for diagnosis of heart failure (HF) is needed. Objectives This study sought to evaluate the diagnostic performance of NT-proBNP for acute HF in patients with dyspnea in the emergency department (ED) setting. Methods Dyspneic patients presenting to 19 EDs in North America were enrolled and had blood drawn for subsequent NT-proBNP measurement. Primary endpoints were positive predictive values of age-stratified cutoffs (450, 900, and 1,800 pg/ml) for diagnosis of acute HF and negative predictive value of the rule-out cutoff to exclude acute HF. Secondary endpoints included sensitivity, specificity, and positive (+) and negative (−) likelihood ratios (LRs) for acute HF. Results Of 1,461 subjects, 277 (19%) were adjudicated as having acute HF. The area under the receiver-operating characteristic curve for diagnosis of acute HF was 0.91 (95% confidence interval [CI]: 0.90 to 0.93; p Conclusions In acutely dyspneic patients seen in the ED setting, age-stratified NT-proBNP cutpoints may aid in the diagnosis of acute HF. An NT-proBNP |
| Databáze: | OpenAIRE |
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