Can brain natriuretic peptide (BNP) be used as a screening tool in general practice?
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.
Schaufelberger
Maria
M
Department of Cardiology, Mölnlycke Primary Health Care and Research Centre, Mölnlycke, Sweden.
Bergh
Claes-Håkan
CH
Caidahl
Kenneth
K
Eggertsen
Robert
R
Furenäs
Eva
E
Lindstedt
Göran
G
Nilsson
Thomas
T
Stefferud
Kari
K
Swedberg
Karl
K
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
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor