B-type natriuretic peptides for the diagnosis of congestive heart failure in dyspneic oldest-old patients.
OBJECTIVE
To evaluate the accuracy of B-type natriuretic peptide (BNP) and amino-terminal pro-brain natriuretic peptide (NT-proBNP) for the diagnosis of congestive heart failure (CHF) in dyspneic patients aged >or=85 years admitted to the Emergency Department (ED), and to define threshold values in this oldest-old population.


METHODS
This study involved 210 oldest-old patients, and 360 patients aged from 65 to 84 years (<85 years), admitted to the ED for dyspnea.


RESULTS
Median BNP and NT-proBNP levels were significantly higher in CHF oldest-old patients (p<0.001). BNP and NT-proBNP threshold values were higher in oldest-old patients (290 and 2800 pg/mL, respectively) compared to that of patients <85 years (270 and 1700 pg/mL, respectively). In a multivariate analysis, both BNP and NT-proBNP were the strongest variables associated with CHF in oldest-old patients. Neither renal function nor gender had impact on the diagnostic utility of the two tests.


CONCLUSIONS
Both BNP and NT-proBNP could potentially be reliable biomarkers for the diagnosis of CHF in oldest-old patients admitted with acute dyspnea to the ED.
Biochemistry A, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France. camille.gobeaux@cch.aphp.fr
Camille
C
Chenevier-Gobeaux
Samuel
S
Delerme
Jean-Christophe
JC
Allo
Martine
M
Arthaud
Yann-Erick
YE
Claessens
Ohvanesse G
OG
Ekindjian
Bruno
B
Riou
Patrick
P
Ray
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012680:Sensitivity and Specificity
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain