title: Can brain natriuretic peptide (BNP) be used as a screening tool in general practice?
abstract: OBJECTIVE
  To investigate plasma brain natriuretic peptide (p-BNP) in consecutive primary care patients for heart failure screening.
  
  
  METHODS
  Open, descriptive.
  
  
  METHODS
  Three primary care clinics, university hospital.
  
  
  METHODS
  291 consecutive patients, > or =40 years.
  
  
  METHODS
  p-BNP and general practitioners estimated probability of CHF.
  
  
  RESULTS
  Median p-BNP was 29 ng/L. In 42% p-BNP was >40 ng/L in the first sample. In 41 patients further investigated, median p-BNP was 98 ng/L, with a correlation between p-BNP and physicians' estimation of probability of heart failure (r=0.469, p<0.0001). New York Heart Association class was correlated to p-BNP (r=0.343, p=0.034). No correlation between ejection fraction and p-BNP was seen.
  
  
  CONCLUSIONS
  P-BNP concentrations in unselected primary care patients of 40 years of age or above were elevated in a larger proportion of patients than previously reported. Owing to the low specificity, p-BNP concentration limits have to be defined before the test can be used for screening in primary care.
authors.affiliation: Department of Cardiology, Mölnlycke Primary Health Care and Research Centre, Mölnlycke, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Schaufelberger
authors.forename: Claes-Håkan
authors.initials: CH
authors.lastname: Bergh
authors.forename: Kenneth
authors.initials: K
authors.lastname: Caidahl
authors.forename: Robert
authors.initials: R
authors.lastname: Eggertsen
authors.forename: Eva
authors.initials: E
authors.lastname: Furenäs
authors.forename: Göran
authors.initials: G
authors.lastname: Lindstedt
authors.forename: Thomas
authors.initials: T
authors.lastname: Nilsson
authors.forename: Kari
authors.initials: K
authors.lastname: Stefferud
authors.forename: Karl
authors.initials: K
authors.lastname: Swedberg
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D005194:Family Practice / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010044:Outpatient Clinics, Hospital; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D013548:Sweden
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor