title: Comparative sensitivities between different plasma B-type natriuretic peptide assays in patients with minimally symptomatic heart failure.
abstract: Plasma B-type natriuretic peptide (BNP) assays have become widely used to diagnose and manage patients with heart failure. However, differences in assay characteristics may have important implications when BNP is used as a screening test for heart failure at a specific cutoff value. We performed a prospective comparison of 2 commercially available assays--one that is a laboratory-based, microparticle enzyme immunoassay (MEIA) that uses EDTA plasma specimens and one that is a point-of-care (POC), single-use fluorescence immunoassay that uses EDTA--anticoagulated whole blood or plasma specimens-in patients with heart failure and healthy controls. Despite the overall concordance between different SNP assays for the diagnosis of heart failure, their sensitivities may differ when compared at the approved diagnostic cutoff value of 100 pg/mL. At this cutoff value, the MEIA on AxSYM demonstrated greater sensitivity than POC Triage BNP assay in minimally symptomatic patients with heart failure. Therefore, for screening purposes, cutoff values for plasma BNP or N-terminal pro-BNP levels should be specific for each assay to optimize test performance. These findings suggest that there is a relationship between the decision statistics used in screening for left ventricular dysfunction and the type of diagnostic assay used.
authors.affiliation: Department of Cardiovascular Medicine, Section of Heart Failure and Cardiac Transplantation Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. tangw@ccf.org
authors.forename: W H Wilson
authors.initials: WH
authors.lastname: Tang
authors.forename: Kiran
authors.initials: K
authors.lastname: Philip
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Hazen
authors.forename: Cindy E
authors.initials: CE
authors.lastname: Stevenson
authors.forename: Michael
authors.initials: M
authors.lastname: Pepoy
authors.forename: Sarah
authors.initials: S
authors.lastname: Neale
authors.forename: Gary S
authors.initials: GS
authors.lastname: Francis
authors.forename: Frederick
authors.initials: F
authors.lastname: Van Lente
authors.forename: Andrew
authors.initials: A
authors.lastname: Smith
authors.forename: Alan H B
authors.initials: AH
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007124:Immunoenzyme Techniques; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain