title: Comparison of the diagnostic accuracy of brain natriuretic peptide (BNP) and the N-terminal part of the propeptide of BNP immunoassays in chronic and acute heart failure: a systematic review.
abstract: BACKGROUND
  We used evidence-based laboratory medicine principles to compare the diagnostic accuracy of brain natriuretic peptide (BNP) and the N-terminal part of the propeptide of BNP (NT-proBNP) assays for the diagnosis of heart failure.
  
  
  METHODS
  In May 2006, we performed a computerized literature search of the online National Library of Medicine to select studies specifically designed to compare the diagnostic accuracy of BNP and NT-proBNP assays. The comparison took into account the area under the curve and diagnostic odds ratio (DOR) derived from ROC analysis of original studies.
  
  
  RESULTS
  Both BNP and NT-proBNP assays were found to be clinically useful for the diagnosis of heart failure. Metaanalysis of these data was difficult because of the heterogeneity of data regarding patient population, diagnostic criteria, end-points, and immunoassay methods for both BNP and NT-proBNP. Separate metaanalyses were performed for acute and chronic heart failure. In chronic heart failure, the diagnostic DOR for BNP (8.44, 95% CI 4.66-15.30) was not significantly different from that of NT-proBNP (23.36, 95% CI 9.38-58.19). In patients with acute heart failure, the mean DOR for BNP (16.46, 95% CI 10.65-25.43) was not significantly different from that of NT-proBNP (18.61, 95% CI 12.99-26.65).
  
  
  CONCLUSIONS
  Our results indicate that both BNP and NT-proBNP assays have a high degree of diagnostic accuracy and clinical relevance for both acute and chronic heart failure.
authors: Laboratory of Cardiovascular Endocrinology, Department of Cardiovascular Medicine, Consiglio Nazionale delle Ricerche Institute of Clinical Physiology, Pisa, Italy. clerico@ifc.cnr.it
authors: Aldo
authors: A
authors: Clerico
authors: Marianna
authors: M
authors: Fontana
authors: Luc
authors: L
authors: Zyw
authors: Claudio
authors: C
authors: Passino
authors: Michele
authors: M
authors: Emdin
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D007118:Immunoassay; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve
chemical_list: D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain