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Value of amino‐terminal pro B‐natriuretic peptide in diagnosing Kawasaki disease
Author(s) -
McNealDavidson Ariane,
Fournier Anne,
Spigelblatt Linda,
SaintCyr Claire,
Mir Thomas S,
Nir Amiram,
Dallaire Frédéric,
Cousineau Jocelyne,
Delvin Edgard,
Dahdah Nagib
Publication year - 2012
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2012.03609.x
Subject(s) - medicine , natriuretic peptide , kawasaki disease , confidence interval , receiver operating characteristic , odds ratio , gastroenterology , area under the curve , prospective cohort study , predictive value , cardiology , predictive value of tests , likelihood ratios in diagnostic testing , heart failure , artery
Background: The aim of the present study was to investigate the diagnostic value of the N‐terminal B‐type natriuretic peptide (NT‐proBNP) in acute Kawasaki disease (KD) given that the clinical criteria and the current basic laboratory tests lack the necessary specificity for accurate diagnosis. Methods: Basic biological tests and serum NT‐proBNP levels obtained from acute KD patients were compared to that of febrile controls. NT‐proBNP was considered abnormal based on the following definitions: above a cut‐off determined on receiver operator characteristic (ROC) analysis, above the upper limit for age, or above 2 SD calculated from healthy children. Analyses were also performed for KD cases with complete or incomplete criteria combined and separately. Results: There were 81 patients and 49 controls aged 3.60 ± 2.77 versus 4.25 ± 3.88 years ( P = 0.69). ROC analysis yielded significant area under the curve for NT‐proBNP. The sensitivity, specificity, positive and negative predictive values were 70.4–88.9%, 69.4–91.8%, 82.8–93.4%, and 65.2–79.1%. The odds ratios based on NT‐proBNP definitions varied between 18.13 (95% confidence interval [CI]: 7.21–45.57), 20.82 (95%CI: 8.18–53.0), and 26.71 (95%CI: 8.64–82.57; P < 0.001). Results were reproducible for cases with complete or incomplete criteria separately. Conclusion: NT‐proBNP is a reliable marker for the diagnosis of KD. Prospective clinical studies with emphasis on NT‐proBNP in a diagnostic algorithm are needed.