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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-24100

Zuber, M; Cuculi, F; Attenhofer Jost, C H; Kipfer, P; Buser, P; Seifert, Burkhardt; Erne, P (2009). Value of brain natriuretic peptides in primary care patients with the clinical diagnosis of chronic heart failure. Scandinavian Cardiovascular Journal : SCJ, 43(5):324-329.

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Introduction. Brain natriuretic peptide (BNP) and N-Terminal pro natriuretic peptide (NT-proBNP) are widely accepted to diagnose congestive heart failure (CHF) in the emergency room. The aim of this study was to evaluate the value of BNP and NT-proBNP to diagnose CHF in primary care. Methods. Clinical and Doppler-echocardiographic assessment of patients referred by their general practitioner (GP) with the diagnosis of CHF. Receiver operating curves were used to evaluate the accuracy of BNP and NT-proBNP for echocardiographically confirmed systolic and/or diastolic heart failure. Results. Three hundred and eighty four patients (mean age of 65) were included. One hundred and ninety three (50%) patients had systolic heart failure and 31 (8%) had isolated diastolic heart failure. Using currently recommended cut-off values of BNP (less than 100pg/ml) and NT-proBNP (less than 125pg/ml) for exclusion of CHF, BNP was false negative in 25% and NT-proBNP in 10% of the patients. The area under the curve was better for NT-proBNP than for BNP (0.742 vs. 0.691). Conclusion. In this population with a high prevalence of CHF, BNP and NT-proBNP failed to adequately rule out CHF. GP's should be cautious when using BNP and NT-proBNP in primary care. An echocardiography remains compulsory in unexplained dyspnea.




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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Deposited On:16 Nov 2009 14:07
Last Modified:02 Jun 2015 07:24
Publisher:Taylor & Francis
Publisher DOI:10.1080/14017430902769919
PubMed ID:19247872

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