Accuracy of N-terminal-pro-atrial natriuretic peptide in patients admitted to emergency department.
OBJECTIVE
B-type natriuretic peptide (BNP) and N-terminal-pro-BNP (Nt-proBNP) are commonly used for the triage of patients in the emergency department (ED) with dyspnoea and/or chest pain. The aim of our study was to determine the accuracy of N-terminal-pro-ANP (Nt-proANP) in such patients.


METHODS
Nt-proANP was measured by home-made radioimmunoassay in 137 ED patients admitted with cardiovascular and/or pulmonary disorders. BNP and Nt-pro-BNP were determined with automated assays. Final diagnosis was confirmed at discharge or after follow-up.


RESULTS
Nt-proANP levels were significantly influenced by the diagnostic subgroups (ANOVA: p<0.001) and were [geometric mean (range)]: 19727 ng/L (5260-45200) in congestive heart failure (CHF, n=31), 6575 ng/L (1350-36000) in coronary artery disease (CAD, n=19), 5324 ng/L (1710-13150) in pulmonary embolism (PE, n=20), 5035 ng/L (1510-16600) in pulmonary diseases (PD, n=24) and 3001 ng/L (750-11860) in patients without cardiopulmonary diseases (n=43). Pairwise comparisons demonstrated that CHF patients had Nt-pro-ANP values higher than all other groups (p<0.05) and that patients without cardiopulmonary diseases had the lowest values (p<0.05). For diagnosis of CHF, the area under the ROC curve of Nt-proANP was 0.94 (95 % CI: 0.89-0.98) and was equivalent to Nt-proBNP (0.91; p=0.284) and BNP (0.93; p=0.572).


CONCLUSIONS
The diagnostic accuracy of Nt-proANP was equivalent to BNP and Nt-proBNP in the present cohort of patients admitted to ED with dyspnoea and/or chest pain.
Gruson
Damien
D
Diabetes and Nutrition Unit, Cliniques Universitaires St-Luc, Brussels, Belgium. gruson_damien@yahoo.fr
Rousseau
Michel F
MF
Ahn
Sylvie
S
Van Linden
François
F
Thys
Frédéric
F
Ketelslegers
Jean-Marie
JM
Verschuren
Franck
F
D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000097:blood; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012372:ROC Curve; D011863:Radioimmunoassay; D012680:Sensitivity and Specificity
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain