Blood Test Confirmed Useful for Heart Failure

A study involving 1,256 patients arriving at emergency rooms with shortness of breath has confirmed the value of a blood test for amino-terminal pro-brain natriuretic peptide (NT-proBNP) for diagnosing suspected acute heart failure.

Prior studies have suggested this usefulness but were restricted to single centers and a small number of patients. In 720 of the current patients, who were diagnosed with acute heart failure, median NT-proBNP levels were considerably higher compared to patients who did not have acute heart failure. As the severity of symptoms rose, levels of NT-proBNP also rose. NT-proBNP is the biologically inert precursor to the heart hormone BNP. Many previous studies have shown BNP as a marker in the diagnosis of congestive heart failure.

The patients in the new study were in New Zealand, Spain, and the Netherlands. Those whose levels of NT-proBNP were greater than 5,180 pg/ml were found to have a fivefold increased risk of death within the study period, compared to patients whose levels were low. The study's findings were reported in the November 17, 2005, online edition of the European Heart Journal.

"The admission NT-proBNP concentration was so strongly predictive of short-term mortality among our patients with acute heart failure that its presence in multi-variable models overwhelmed the prognostic impact of other traditional risk factors for mortality, such as age or NYHA [New York Heart Association] classification,” wrote the study authors.

"In conclusion, in the first large-scale international analysis of NT-proBNP testing for evaluating patients with suspected acute heart failure, we demonstrate the utility of NT-proBNP testing for both diagnosis and exclusion of acute heart failure. As well, we demonstrate the value of NT-proBNP for the short-term estimation of risk for mortality in acute heart failure,” the authors concluded. The study was led by James L. Januzzi, of the Massachusetts General Hospital (Boston, MA, USA).