Usefulness of natriuretic peptides in primary health care: an exploratory study in elderly patients.
OBJECTIVE
To explore the negative predictive value (NPV), positive predictive value (PPV), sensitivity, and specificity of natriuretic peptides, cut-off levels, and the impact of gender and age in elderly patients with systolic heart failure (HF).


METHODS
Cross-sectional exploratory study.


METHODS
One primary healthcare centre.


METHODS
A total of 109 patients with symptoms of HF were referred for echocardiographic examination with a cardiovascular consultation. Systolic HF was diagnosed (ESC guidelines) in 48 patients (46% men, 54% women, mean age 79 years) while 61 patients (21% men, 79% women, mean age 76 years) had no HF.


METHODS
NPV, PPV, sensitivity, specificity, and cut-off levels.


RESULTS
Including all 109 patients, NPV was 88% for NT-proBNP (200 ng/L) and 87% for BNP (20 pg/ml). PPV was 81% for NT-proBNP (500 ng/L) and 68% for BNP (50 pg/ml). Sensitivity was 96% for NT-proBNP (100 ng/L) and 96% for BNP (10-20 pg/ml). Specificity was 87% for NT-proBNP (500 ng/L) and 71% for BNP (50 pg/ml). Nt-proBNP (beta = 0.035; p < 0.001) and BNP (beta = 0.030; p < 0.001) were associated with age, but not with gender. In a multivariate analysis age (beta = 0.036; p < 0.001) and male gender (beta = 0.270; p = 0.014) were associated with NT-proBNP, but only age for BNP (beta = 0.030; p < 0.001).


CONCLUSIONS
Natriuretic peptides in an elderly population showed high NPVs, but not as high as in younger patients with HF in other studies. Age and male gender were associated with higher levels of NT-proBNP while only age was related to elevated BNP levels.
Olofsson
Mona
M
Department of Medicine, Skellefteå County Hospital, Skellefteå, Sweden. olofsson@vll.se
Boman
Kurt
K
D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D003151:Community Health Centers; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D054144:Heart Failure, Diastolic / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D054143:Heart Failure, Systolic / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014463:Ultrasonography
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain