Brain Natriuretic Peptide and Breathing Not Properly: The Merger of 2 BNPs

Featured Article: Maisel A, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 2002;347:161–7.2The idea for the Breathing Not Properly Study came from a preliminary study that we performed in our emergency department. I begged for devices to measure brain natriuretic peptide (BNP) from Biosite, an up-and-coming point-of-care company located in San Diego. The company's BNP marketing director, Scott Mader, made sure I had enough kits for our preliminary study (1). Our results showed 90% diagnostic accuracy! We found that many patients who were being followed for chronic obstructive pulmonary disease actually had heart failure (an echocardiogram doesn't always pick it up). Because this observation could be a game changer, we needed to convince Biosite to fund a multicenter trial, which had never before been done at a “diagnostic lab” company. If …