BNP Testing and the Accuracy of Heart Failure Diagnosis in the Emergency Department.
Circ Heart Fail. 2009 Nov 20;
Authors: Lokuge A, Lam LL, Cameron P, Krum H, Smit DV, Bystrzycki A, Naughton MT, Eccleston D, Flannery G, Federman J, Schneider HG
BACKGROUND: -It is often difficult to diagnose heart failure (HF) accurately in patients presenting with dyspnoea to the emergency department (ED). This study assessed whether B-type Natriuretic Peptide (BNP) testing in these patients improved the accuracy of HF diagnosis. METHODS AND RESULTS: -Patients presenting to The Alfred and The Northern Hospital EDs with a chief complaint of dyspnoea were enrolled prospectively from August 2005 to April 2007. Patients were randomly allocated to have BNP levels tested or not. The diagnostic "gold" standard for HF was determined by one cardiologist and one emergency or respiratory physician who, blinded to the BNP result, independently reviewed all available information. The ED diagnosis of HF in the non BNP group, showed a sensitivity, specificity and accuracy of 65%, 92% and 81% respectively. The BNP group had a similar sensitivity, specificity and accuracy of 66%, 90% and 78% respectively for the diagnosis of HF in the ED. There was no significant difference between the BNP and non BNP groups in any of the measures of diagnostic accuracy for HF. CONCLUSIONS: -In the clinical setting of emergency departments, availability of BNP levels did not significantly improve the accuracy of a diagnosis of HF.
PMID: 19933409 [PubMed - as supplied by publisher]