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Comparison of B‐type natriuretic peptide assays for identifying heart failure in stable elderly patients with a clinical diagnosis of chronic obstructive pulmonary disease
Author(s) -
Rutten Frans H.,
Cramer MaartenJan M.,
Zuithoff Nicolaas P.A.,
Lammers JanWillem J.,
Verweij Wim,
Grobbee Diederick E.,
Hoes Arno W.
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2007.01.010
Subject(s) - medicine , heart failure , natriuretic peptide , cardiology , pulmonary disease , intensive care medicine
Aims: To compare the ability of different B‐type natriuretic peptide (BNP) assays to identify heart failure in stable elderly patients with a diagnosis of chronic obstructive pulmonary disease (COPD). Methods: 200 patients aged ≥65 years with COPD according to their general practitioner and without known heart failure, underwent a diagnostic work‐up. The final diagnosis of heart failure was established by a panel using the diagnostic principles of the European Society of Cardiology. All available diagnostic results, including echocardiography, but not BNP or NT‐proBNP measurements, were used. The ability of different B‐type natriuretic peptide assays to identify heart failure was estimated using the area under the receiver operating characteristic curves (ROC‐area). Results: The ROC‐areas did not differ significantly between the various assays of NT‐proBNP and BNP, and ranged from 0.68 (95%CI 0.60–0.73) to 0.73 (95%CI 0.64–0.81). For NT‐proBNP the age‐ and gender‐independent “optimal” cut‐point was 15 pmol/l (125 pg/ml) and for BNP 10 pmol/l (35 pg/ml). All assays were much better at excluding than detecting heart failure. Conclusions: All assays of B‐type natriuretic peptide showed reasonable and comparable accuracy in recognising heart failure. At “optimal” cut‐points, all assays performed better at excluding than detecting new cases of heart failure in this population.