title: The differential diagnostic value of serum NT-proBNP in hospitalized patients of heart failure with pneumonia.
abstract: Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) is considered as an effective predictor for patients with heart failure (HF), while a strong body of evidence has found its utility in inflammatory diseases. It is difficult to differentiate HF and HF coexisting with other inflammations by measuring NT-proBNP. The aim of this study was to estimate the differential diagnostic performance of serum NT-proBNP in hospitalized HF patients with pneumonia. A prospective study was launched. Sixty nine HF patients, 51 HF patients complicated with pneumonia, and 38 patients with pneumonia were enrolled. Serum NT-proBNP levels were measured on Roche Elecsys. X-ray and the European Society of Cardiology (ESC) diagnostic principles were adopted to identify patients with pneumonia and HF, respectively. The diagnostic performance of NT-proBNP was assessed by ROC. Serum NT-proBNP [7,039(1,008-24,672) pg/ml] in patients of HF complicated with pneumonia was significantly higher than that in those of patients with single HF [3,147(616-24,062) pg/ml] or single pneumonia [911(98-3,812) pg/ml] (P < 0.0001). No correlation was found between the level of NT-proBNP and hospital stay. The area under ROC curve (AUC) of NT-proBNP for distinguishing patients of HF with pneumonia was 0.8082. At the level of 4,691 pg/ml, the optimal cutoff value, 74.5% sensitivity and 81.8% specificity of NT-proBNP were predicted. Evaluation of serum NT-proBNP is conducive for clinicians to identify patients of HF with pneumonia, but its poor efficacy in monitoring the curative therapy in this entire cohort is not recommended.
authors.affiliation: Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.
authors.forename: Shuangshuang
authors.initials: S
authors.lastname: Yang
authors.forename: Linbin
authors.initials: L
authors.lastname: Li
authors.forename: Ju
authors.initials: J
authors.lastname: Cao
authors.forename: Hongsong
authors.initials: H
authors.lastname: Yu
authors.forename: Huajian
authors.initials: H
authors.lastname: Xu
mesh_terms: D000328:Adult; D001839:Bombesin / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011014:Pneumonia / Q000097:blood* / Q000150:complications; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D013223:Statistics as Topic; D014965:X-Rays
chemical_list: D010446:Peptide Fragments; D011498:Protein Precursors; C052905:human probombesin C-terminal peptide; D001839:Bombesin
keywords: HF; NT-proBNP; differential diagnosis; pneumonia