Peptide Test Identifies ED Patients with CHF

A study has demonstrated the diagnostic usefulness of B-type natriuretic peptide (BNP) testing as a predictor of congestive heart failure (CHF) in patients presenting at the emergency department (ED) with shortness of breath. The findings were presented at the annual scientific session of the American College of Cardiology in Atlanta (GA, USA).

The study involved seven international centers and 1,586 patients arriving at the ED with acute dyspnea. BNP levels in the patients were measured with a BNP test upon their arrival. BNP is a naturally occurring hormone in the body that aids the functioning of the heart and is secreted by the ventricles of the heart as a response to heart failure. ED doctors, blinded to the results of the measurements, were asked to provide a diagnosis and a probability of CHF using traditional clinical diagnostic tools, such as physical exam, x-ray, and patient history. The final determination was then made by two cardiologists, also blinded to BNP results as well as the diagnosis by ED doctors.

The cardiologists found that BNP levels by themselves were more accurate than any historical or physical findings or laboratory values in identifying causes of dyspnea. A BNP cutoff of 100 pg/ml had a sensitivity of 90%, a specificity of 74%, and an accuracy of 81.1% for differentiating congestive heart failure from other causes of dyspnea. The test used in the study was the 15-minute Triage BNP test of Biosite Inc. (San Diego, CA, USA).

"In the study, BNP was the single most accurate predictor of congestive heart failure,” said Alan Maisel, M.D., director of the coronary care unit at the San Diego, CA, Veterans Affairs Healthcare System (USA) and one of the clinical investigators. "BNP performed better than both the US National Health and Nutrition and Examination Survey and the Framingham criteria, arguably the most accepted definition for congestive heart failure diagnosis.”




Related Links:
Biosite