Key result
NT-proBNP screening detects confirmed chronic heart failure in ~6% of elderly COPD patients.
Why the study?
Can NT-proBNP testing effectively detect chronic heart failure in elderly patients with COPD?
Cross-Sectional (n=53)
Yes
Can NT-proBNP testing effectively detect chronic heart failure in elderly patients with COPD?
NT-proBNP testing identified a lower than expected prevalence (5.6%) of concurrent chronic heart failure in elderly patients with COPD in primary care.
Answers are grounded in this paper and cite their sources.
NT-proBNP screening yielded low HF detection in elderly COPD patients; hypothesis-generating and does not support routine use without larger studies.
Objective. To detect chronic heart failure in elderly patients with a registered diagnosis of chronic obstructive pulmonary disease (COPD) treated in Swedish primary health care using natriuretic peptide NT-proBNP. Design. A cross-sectional study. Setting. Two primary health care centres in southeastern Sweden each with about 9000 listed patients. Subjects. Patients aged 65 years and older with a registered diagnosis of COPD. Main Outcome Measures. Percentage of patients with elevated NT-proBNP, percentage of patients with abnormal left ventricular function assessed by echocardiography, and association between elevated NT-proBNP and symptoms, signs, and electrocardiography. Results. Using NT-proBNP threshold of 1200 pg/mL, we could detect and confirm chronic heart failure in 5.6% of the study population with concurrent COPD. An elevated level of NT-proBNP was only associated with nocturia and abnormal electrocardiography. Conclusions. We found considerably fewer cases of heart failure in patients with COPD than could be expected from the results of previous studies. Our study shows the need for developing improved strategies to enhance the validity of a suspected heart failure diagnosis in patients with COPD.
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Kaszuba et al. (2013) conducted a cross-sectional in Chronic obstructive pulmonary disease (COPD) with suspected chronic heart failure (n=53). NT-proBNP screening (threshold ≥1200 pg/mL) vs. NT-proBNP <1200 pg/mL was evaluated on Confirmed chronic heart failure (elevated NT-proBNP ≥1200 pg/mL and abnormal left ventricular function on echocardiography). NT-proBNP screening (≥1200 pg/mL) followed by echocardiography detected and confirmed chronic heart failure in 5.6% (3/53) of elderly primary care patients with COPD.
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