Effect of <scp>NT</scp>‐pro‐<scp>BNP</scp> Assay on Accuracy and Confidence of General Practitioners in Diagnosing Heart Failure or Respiratory Disease in Cats with Respiratory Signs

Singletary, Gretchen E.; Fox, Philip R.; Stepien, Rebecca L.; Oyama, Mark A.

doi:10.1111/j.1939-1676.2012.00916.x

Cited by 32 publications

(23 citation statements)

References 23 publications

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“…High sensitivity cTnI remained significant; however, likely reflecting its ability to detect myocardial cellular damage . Although the ability of cardiac biomarkers to discriminate between cardiac and respiratory causes of tachypnea in cats is well‐established, our results show the additional prognostic value of measuring cTnI in cats with HCM and CHF.…”

Section: Discussionmentioning

confidence: 63%

“…The use of circulating cardiac troponin I (cTnI) and N‐terminal pro‐B‐type natriuretic peptide (NTproBNP) concentrations to assist diagnosis, guide treatment, and screen individuals for HCM has recently received much attention in human and veterinary cardiology research . However, little information is available on the prognostic value of circulating biomarker concentrations in HCM.…”

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confidence: 99%

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Plasma Cardiac Troponin I Concentration and Cardiac Death in Cats with Hypertrophic Cardiomyopathy

Borgeat

Sherwood

Payne

et al. 2014

Veterinary Internal Medicne

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BackgroundThe use of cardiac biomarkers to assist in the diagnosis of occult and symptomatic hypertrophic cardiomyopathy (HCM) in cats has been established. There is limited data describing their prognostic utility in cats with HCM.HypothesisCirculating concentrations of N‐terminal B‐type natriuretic peptide (NTproBNP) and cardiac troponin I (cTnI) predict cardiac death in cats with HCM.AnimalsForty‐one cats diagnosed with HCM at a veterinary teaching hospital, between February 2010 and May 2011.MethodsProspective investigational study. Plasma samples were collected from cats diagnosed with HCM and concentrations of NTproBNP and cTnI were analyzed at a commercial laboratory. Echocardiographic measurements from the day of blood sampling were recorded. Long‐term outcome data were obtained. Associations with time to cardiac death were analyzed using Cox proportional hazards models.ResultsWhen controlling for the presence/absence of heart failure and echocardiographic measures of left atrial size and function, cTnI > 0.7 ng/mL was independently associated with time to cardiac death. In univariable analysis, NTproBNP > 250 pmol/L was associated with cardiac death (P = .023), but this did not remain significant (P = .951) when controlling for the effect of clinical signs or left atrial size/function.Conclusions and Clinical ImportancePlasma concentration of cTnI (cutoff >0.7 ng/mL) is a predictor of cardiac death in cats with HCM that is independent of the presence of heart failure or left atrial dilatation.

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Section: Discussionmentioning

confidence: 63%

mentioning

confidence: 99%

Plasma Cardiac Troponin I Concentration and Cardiac Death in Cats with Hypertrophic Cardiomyopathy

Borgeat

Sherwood

Payne

et al. 2014

Veterinary Internal Medicne

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“…Having a biomarker‐guided therapy may be even more important as a complement to other testing in cats compared to people to improve clinicians’ confidence in diagnosing heart disease or making treatment decisions for cats with CHF. NT‐proBNP has already been shown to increase the accuracy and confidence of general practitioners in diagnosing CHF in dyspneic cats; accuracy without NT‐proBNP was 67%, and the accuracy improved to 87% with the addition of NT‐proBNP test results 28. In studies of people with CHF, a decrease in BNP >30% during hospitalization predicted a 45% decrease in mortality risk or >40% survival advantage 24.…”

Section: Discussionmentioning

confidence: 99%

Association between Survival Time and Changes inNT‐proBNPin Cats Treated for Congestive Heart Failure

Pierce

Freeman

Cunningham

et al. 2017

Veterinary Internal Medicne

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BackgroundReductions in N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentrations after treatment have been associated with improved survival in people with congestive heart failure (CHF), but have not been reported in cats with CHF.ObjectivesTo evaluate changes in NT‐proBNP concentrations in cats with CHF after treatment and determine whether serial NT‐proBNP measurements provide prognostic information.AnimalsThirty‐one client‐owned cats.MethodsProspective, observational study in cats with new onset CHF secondary to cardiomyopathy. Concentrations of NT‐proBNP were measured within 4 hours of admission to the hospital, on the day of discharge, and at re‐evaluation 7–10 days later.ResultsMedian NT‐proBNP concentrations decreased significantly from admission (1,713 pmol/L [range, 160–3,784 pmol/L]) to discharge (902 pmol/L [range, 147–3,223 pmol/L]); P = .005) and from admission to re‐evaluation (1,124 pmol/L [range, 111–2,727 pmol/L]; P = .024). Median survival time was 109 days (range, 1–709 days), with 5 cats still alive at the time of analysis. Cats with a larger percent decrease in NT‐proBNP from admission to discharge had a longer survival time (P = .048). Cats with evidence of active CHF at the time of re‐evaluation (P = .010) and cats whose owners had difficulty administering medications (P = .045) had shorter survival times.Conclusions and clinical importanceCats with a larger percent decrease in NT‐proBNP during hospitalization and no evidence of CHF at the time of re‐evaluation had longer survival times. Additional studies are needed to determine whether NT‐proBNP can help guide treatment in cats with CHF.

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“…6 The second-generation feline NT-proBNP immunoassay accurately measures levels of NT-proBNP, which are often elevated in cats with cardiac disease, and the use of this test can improve diagnostic accuracy. 11 However, levels of NT-proBNP may also be elevated due to concurrent diseases such as hypertension, hyperthyroidism, and severe azotemia. 9 The use of the feline NT-proBNP immunoassay, therefore, should be included as part of a more comprehensive diagnostic work-up for cats at risk for cardiac disease.…”

Section: Discussionmentioning

confidence: 99%

Analytical validation of an immunoassay for the quantification of N-terminal pro–B-type natriuretic peptide in feline blood

et al. 2015

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The measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), a biomarker for heart stress detectable in blood, has been shown to have clinical utility in cats with heart disease. A second-generation feline enzyme-linked immunosorbent assay (Cardiopet® proBNP, IDEXX Laboratories Inc., Westbrook, Maine) was developed to measure NT-proBNP in routine feline plasma or serum samples with improved analyte stability. Results of the analytical validation for the second-generation assay are presented. Analytic sensitivity was 10 pmol/l. Accuracy of 103.5% was determined via serial dilutions of 6 plasma samples. Coefficients of variation for intra-assay, interassay, and total precision were in the ranges of 1.6-6.3%, 4.3-8.8%, and 10.1-15.1%, respectively. Repeatability across 2 lots for both serum and plasma had an average coefficient of determination (r(2)) of 0.99 and slope of 1.11. Stability of the analyte was found to be high. In serum samples held at 4°C for 24-72 hr, the mean percent recovery from time zero was ≥99%. In serum samples held at 25°C for 24 hr, the mean percent recovery from time zero was 91.9%, and for 48 hr, 85.6%. A method comparison of the first- and second-generation assays with a clinically characterized population of cats revealed no difference in the tests' ability to differentiate levels of NT-proBNP between normal cats and cats with occult cardiomyopathy (P < 0.001). Results from our study validate that the second-generation feline Cardiopet proBNP assay can measure NT-proBNP in routine feline plasma and serum samples with accuracy and precision.

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Effect of NT‐pro‐BNP Assay on Accuracy and Confidence of General Practitioners in Diagnosing Heart Failure or Respiratory Disease in Cats with Respiratory Signs

Cited by 32 publications

References 23 publications

Plasma Cardiac Troponin I Concentration and Cardiac Death in Cats with Hypertrophic Cardiomyopathy

Plasma Cardiac Troponin I Concentration and Cardiac Death in Cats with Hypertrophic Cardiomyopathy

Association between Survival Time and Changes inNT‐proBNPin Cats Treated for Congestive Heart Failure

Analytical validation of an immunoassay for the quantification of N-terminal pro–B-type natriuretic peptide in feline blood

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