NT-pro-BNP for differential diagnosis in patients with syncope.
NT-pro-BNP has been proposed as a good predictor of syncope adverse outcome in the Emergency Department (ED) [Pfister R, Diedrichs H, Larbig R, Erdmann E, Schneider CA. NT-pro-BNP for differential diagnosis in patients with syncope. Int J Cardiol 2008 Jan 29]. We hereby summarize four critical points that should be taken into account when seeking to identify a cardiac cause of syncope or dealing with a risk stratification approach of the patient in the ED. The first issue is that patients admitted to the hospital after syncope are usually sicker than those discharged because of a higher rate of co-morbidity. Secondly, the focus on discharged patients is of paramount importance to assess the goodness of a predictor. Aging, which affects NT-pro-BNP levels, is a limiting factor in interpreting results. Finally, in order to add valuable information to the clinical practice, we suggest to compare results obtained by NT-pro-BNP values and the most used prognostic risk scores, such as the OESIL and SFSR.
Costantino
Giorgio
G
Solbiati
Monica
M
Pisano
Giuseppina
G
Furlan
Raffaello
R
D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D022062:Electrophysiologic Techniques, Cardiac; D004636:Emergency Service, Hospital; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D013575:Syncope / Q000175:diagnosis / Q000209:etiology*; D013686:Telemetry
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain