NT-proBNP detected severe systolic dysfunction with an AUC of 0.83 and any systolic LV-dysfunction with an AUC of 0.77, showing no clinically significant advantage over BNP testing.
Observational (n=339)
Effect estimate: AUC 0.83
OBJECTIVES: B-type natriuretic peptide (BNP) is a strong diagnostic predictor of left-ventricular (LV)-dysfunction. Recently, the aminoterminal portion of pro-BNP (NT-proBNP) has been introduced, which could be even more sensitive because of its longer half-life. The aim of this study was to evaluate the new marker NT-proBNP within a large, heterogeneous population of patients with suspected cardiovascular disease at risk of cardiovascular dysfunction and to compare it with the established diagnostic parameter BNP. SUBJECTS AND METHODS: NT-proBNP and BNP were measured in 339 hospitalised patients undergoing diagnostic angiography (median age 66 years, 244 male vs. 95 female). RESULTS: Median values of NT-proBNP increased with worsening LV-dysfunction and higher NYHA class. The area under the receiver operator characteristics curve (AUC) of NT-proBNP for detecting severe systolic dysfunction or for detecting any systolic LV-dysfunction was 0.83 and 0.77, respectively. The latter improved (AUC=0.81) when patients with clinically relevant heart disease like valvular dysfunction were included, independent of the haemodynamic values. Compared to BNP, NT-proBNP tended to be more accurate in identifying lesser degrees of LV-dysfunction. CONCLUSIONS: Even after optimisation of target criteria, there was still a substantial overlap of NT-proBNP values between patients with and without relevant heart disease. Therefore, NT-proBNP is not suitable as a screening test for LV-dysfunction in the community. Nevertheless, because of its good negative predictive value, NT-proBNP could be an easy and effective tool to rule out severe systolic LV-dysfunction in high risk patients. No clinically significant advantage of BNP testing could be found.
Pfister et al. (Sat,) conducted a observational in Suspected cardiovascular disease (n=339). NT-proBNP vs. BNP was evaluated on Detection of severe systolic dysfunction (AUC 0.83). NT-proBNP detected severe systolic dysfunction with an AUC of 0.83 and any systolic LV-dysfunction with an AUC of 0.77, showing no clinically significant advantage over BNP testing.
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