The Beckman Coulter Access NT-proBNP assay accurately diagnosed acute heart failure in dyspneic emergency department patients, yielding an AUC of 0.87 (P<0.001) and a 95% negative predictive value.
Observational (n=490)
Yes
Does the Beckman Coulter Access NT-proBNP assay accurately diagnose or exclude acute heart failure in dyspneic patients presenting to the emergency department?
The novel Beckman Coulter Access NT-proBNP assay demonstrates high diagnostic accuracy for acute heart failure in emergency department patients, performing comparably to existing validated assays.
Effect estimate: AUC 0.87
p-value: p=<0.001
OBJECTIVES: NT-proBNP is widely measured for the diagnosis of acute heart failure (HF). This study assessed the diagnostic performance of a novel N-terminal pro-B type natriuretic peptide (NT-proBNP) assay in evaluating the dyspneic patient in the acute care setting. METHODS: This was a multicenter study of individuals presenting to the emergency department exhibiting clinical symptoms potentially due to acute HF. Blood was drawn for NT-proBNP assessment using the Beckman Coulter Access NT-proBNP assay with results compared to adjudicated diagnoses. Endpoints included negative predictive value and sensitivity of an age-independent cut point of 450, >900, and >1800 ng/L for ages 75 years, respectively, for the diagnosis of acute HF. RESULTS: 490 study participants were included, of which 41 % were adjudicated as having acute heart failure. The assay had an area under the receiver-operator characteristic curve (AUC) for the diagnosis of acute HF of 0.87 (P < 0.001), comparable AUC to other commercially available NT-proBNP assays. A rule-out cut point of <300 ng/L had 96 % sensitivity and negative predictive value of 95 %. Age-dependent cut points had sensitivity of 84 %, 90 %, and 87 %, specificity of 81 %, 70 % and 61 %, and positive predictive value of 72 %, 62 %, and 74 %, respectively. CONCLUSIONS: This novel NT-proBNP assay demonstrated high clinical performance in the diagnosis and exclusion of acute HF in the undifferentiated dyspneic patient and performed similarly well to validated assays used in clinical practice.
Guidi et al. (Mon,) conducted a observational in Acute heart failure (n=490). Beckman Coulter Access NT-proBNP assay vs. Adjudicated diagnoses was evaluated on Negative predictive value and sensitivity of an age-independent cut point of < 300 ng/L to exclude acute HF, and positive predictive value of age-dependent cut points (AUC 0.87, p=<0.001). The Beckman Coulter Access NT-proBNP assay accurately diagnosed acute heart failure in dyspneic emergency department patients, yielding an AUC of 0.87 (P<0.001) and a 95% negative predictive value.
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