Amino-terminal pro-B-type natriuretic peptide testing to assist the diagnostic evaluation of heart failure in symptomatic primary care patients.
When used for the evaluation of symptomatic patients in general practice, amino-terminal pro-B-type natriuretic peptide (NT-proBNP) testing is highly sensitive, with an excellent negative predictive value for cost-effective exclusion of the diagnosis of heart failure (HF). Importantly (similar to other NP assays), lower values for NT-proBNP are expected among patients with HF in the primary care setting compared with patients with acute dyspnea. Among primary care patients with dyspnea, a noncardiac source of dyspnea is most likely in patients with findings below the recommended age-stratified NT-proBNP cut points. Conversely, an NT-proBNP result above the age-stratified primary care cut points does not absolutely indicate the presence of HF; a more directed cardiovascular workup is indicated.
Hildebrandt
Per
P
Department of Internal Medicine and Cardiology, Roskilde University Hospital, Roskilde, Denmark. p.hildebrandt@dadlnet.dk
Collinson
Paul O
PO
D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D003935:Diagnostic Techniques, Cardiovascular; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010045:Outpatients; D010446:Peptide Fragments / Q000097:blood*; D011320:Primary Health Care / Q000379:methods*; D011379:Prognosis; D011498:Protein Precursors; D012720:Severity of Illness Index
D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain