NT-proBNP in the differential diagnosis of acute dyspnea in the emergency department

Correlation and Prognostic Utility of B-Type Natriuretic Peptide and Its Amino-Terminal Fragment in Patients With Chronic Kidney Disease

“…These natriuretic peptide concentrations are significantly higher than the currently recommended diagnostic cutoffs for CHF, even when incorporating recently suggested increases to the NT-proBNP cutoff. [31][32][33] This discrepancy highlights the importance of establishing adjusted diagnostic cut points for BNP and NT-proBNP for the diagnosis of CHF exacerbation in patients with both systolic dysfunction and renal impairment.…”

Comprehensive Review of the Relative Clinical Utility of B-Type Natriuretic Peptide and N-Terminal Pro-B-Type Natriuretic Peptide Assays in Cardiovascular Disease

“…Using tests for BNP or NT-proBNP improves diagnosis of HF in patients presenting with acute dyspnea in the ED as demonstrated in several seminal studies (Tables 1 & 2) [12,[34][35][36][37][38][39][40][41]. The use of optimal cutoff values allows physicians to quickly rule out or rule in HF as a cause of patient symptoms.…”

“…A recent meta-analysis of the studies of the usefulness of BNP testing determined that testing for BNP was useful for improving accurate diagnosis of HF in ED patients presenting with acute dyspnea, particularly when the symptoms of HF were mild [29]. Multiple studies have shown that NT-proBNP is also highly useful in diagnosing dyspneic patients in the ED (Table 2) [39,40]. The ProBNP Investigation of Dyspnea in the ED (PRIDE) study (N=600) evaluated whether using NT-proBNP assay could enhance the accuracy of HF diagnoses in ED patients [43,44].…”

“…Multiple single center studies demonstrated the usefulness of BNP as a diagnostic tool in the ED [12,[34][35][36][37][38][39][40][41] and this was validated by the Breathing Not Properly (BNP) Multinational Study [42]. In this study, BNP was tested in a large (N=1586) multicenter, prospective, blinded, and adjudicated format, and it demonstrated that utilization of BNP testing lead to more accurate diagnoses than ED physician judgment based on patient history, physical findings, chest xray, and other laboratory values [42].…”

The Diagnostic Value of B Natriuretic Peptide in Elderly Patients with Acute Dyspnea

“…Inappropriate emergency treatment occurred in 162 (32%) patients, and led to a higher mortality (25% versus 11%; p Ͻ 0.001), highlighting the importance of an early accurate treatment in the ED. Numerous studies have evaluated and validated both natriuretic peptides in the diagnosis of CHF in middle-aged patients with acute dyspneoa 26,[30][31][32][33][34][35][36][37][38][39][40][41] ( Tables 2 and 3). All studies used the same methodology, with a measurement of BNP at admission in dyspneic patients in the emergency room.…”