The N-terminal Pro-BNP Investigation of Dyspnea in the Emergency department (PRIDE) study

Januzzi, James L.; Camargo, Carlos A.; Anwaruddin, Saif; Baggish, Aaron L.; Chen, Annabel A.; Krauser, Daniel G.; Tung, Roderick; Cameron, Renee; Nagurney, John Tobias; Chae, Claudia U.; Lloyd‐Jones, Donald M.; Brown, David F.M.; Foran-Melanson, Stacy; Sluss, Patrick M.; Lee-Lewandrowski, Elizabeth; Lewandrowski, Kent

doi:10.1016/j.amjcard.2004.12.032

Cited by 1,092 publications

(826 citation statements)

References 24 publications

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“…First, the diagnostic performance of both NT‐proBNP and MR‐proANP for the diagnosis of AHF is excellent ( Figure 2 A ) confirming previous studies1, 2, 3, 16, 17 and thus fully supporting current guideline recommendations on the use of NPs for rule‐out of AHF 18…”

Section: Discussionsupporting

confidence: 83%

“…On the basis of the proBNP investigation of dyspnoea in the emergency department (PRIDE) study classification,3 grey zone NT‐proBNP values were defined as values above 300 ng/L but below 450 ng/L if age was below 50 years, from above 300 ng/L but below 900ng/L if age was between 50 and 75 years, and above 300 ng/L but below 1800 ng/L if age was 75 years or older 5. Severe kidney failure was defined as an estimated glomerular filtration rate of 60 mL/min/1.73 m 2 or less using the modification of diet in renal disease formula 6…”

Section: Methodsmentioning

confidence: 99%

“…For this purpose, brain‐type natriuretic peptide (BNP), N‐terminal pro brain‐type natriuretic peptide (NT‐proBNP) or atrial natriuretic peptide (ANP) collectively designated as natriuretic peptides (NPs) have been recommended by practice guidelines for rule‐out used at pre‐specified and validated cut‐offs 1, 2, 3, 4. However, the performance of NP levels for the diagnosis of AHF has been reported to be less accurate in the setting of renal failure, and obesity as well as advanced age may confound interpretation of NP levels.…”

Section: Introductionmentioning

confidence: 99%

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Comparative accuracy of NT‐proBNP and MR‐proANP for the diagnosis of acute heart failure in dyspnoeic patients

et al. 2017

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AimsTo compare the performance of the natriuretic peptides (NPs) NT‐proBNP and MR‐proANP for the diagnosis of acute heart failure (AHF) in subsets of conditions potentially confounding the interpretation of NPs.Methods and resultsWe studied 312 patients, presenting to the emergency department with new onset of dyspnoea or worsening of chronic dyspnoea within the last 2 weeks. Performance of NPs for the diagnosis of AHF was tested and compared using C‐statistics in the entire cohort and in conditions previously described to confound interpretation of NPs such as older age, renal failure, obesity, atrial fibrillation or paced rhythm, and in the NT‐proBNP grey zone. AHF was diagnosed in 139 patients. In the entire cohort, the diagnostic performance of NT‐proBNP was comparable with that of MR‐proANP. Receiver operating characteristic analysis demonstrated that optimal diagnostic cut‐offs were higher in the presence of older age, kidney failure or rhythm disorder. However, there were no statistically relevant differences between the receiver operating characteristic curves analysed in the total population and those studied in the pre‐specified subsets severe kidney failure, advanced age, obesity, atrial fibrillation and paced rhythm, and grey zone NT‐proBNP values. Moreover, the diagnostic performance of NT‐proBNP was comparable with that of MR‐proANP in the subsets.ConclusionsThe performance of NT‐proBNP and MR‐proANP for AHF is comparable in the total population as well as in the subsets with potentially confounding characteristics such as older age, renal dysfunction, obesity, atrial fibrillation and paced rhythm, or those with NT‐proBNP values in the grey zone.

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Section: Discussionsupporting

confidence: 83%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative accuracy of NT‐proBNP and MR‐proANP for the diagnosis of acute heart failure in dyspnoeic patients

et al. 2017

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“…Immunoassays are available for both molecules and are used clinically to aid diagnosis of HF in patients with shortness of breath. NT‐proBNP has been shown to be both sensitive and specific for HF 56. A comparison of natriuretic peptide levels with BMI was performed using a cohort of 3389 patients without HF from the Framingham population.…”

Section: Natriuretic Peptides In Obesitymentioning

confidence: 99%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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Obesity and heart failure are two of the leading causes of morbidity and mortality in the world. The relationship between obesity and cardiovascular diseases is complex and not fully understood. While the risk of developing heart failure has been shown to be higher in patients who are obese, there is a survival advantage for obese and overweight patients compared with normal weight or low weight patients. This phenomenon was first described by Horwich et al. and was subsequently confirmed in other large trials. The advantage exists irrespective of the type, aetiology, or stage of heart failure. Patients with morbid obesity (body mass index >40 kg/m2), however, do not have the same survival advantage of their obese counterparts. There are several alternative indices of obesity available that may be more accurate than body mass index. The role of weight loss in patients with heart failure is unclear; thus, providing sound clinical advice to patients remains difficult. Future prospective trials designed to evaluate the link between obesity and heart failure will help us understand more fully this complex relationship.

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“…Plasma NT-proBNP was determined using the Elecsys proBNP sandwich immunoassay on an Elecsys 2010 (Roche Diagnostics, Basel, Switzerland). Two cut offs for NT-proBNP were selected before the analyses, 300 pg/ml and 600 pg/ml, with a value of less than 300 pg/ml shown to be optimal for ruling out HF [18]. BNP was determined using the Shionoria immunoradiometric assay kit [19].…”

Section: Nt-probnp and Bnpmentioning

confidence: 99%

BNP and NT‐proBNP predict echocardiographic severity of diastolic dysfunction

Grewal

McKelvie

Lonn

et al. 2008

European J of Heart Fail

108

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Aims: To evaluate the best combination of clinical parameters and brain natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP), to predict diastolic dysfunction (DD) in heart failure with preserved left ventricular ejection fraction (HF-PLEF) as determined by Dopplerechocardiography. Methods and Results: HF patients with EF N 40% in the CHARM Echocardiographic Substudy were included and classified to have normal diastolic function, or mild, moderate or severe diastolic dysfunction. Plasma BNP and NT-proBNP levels were measured and relevant clinical characteristics recorded. 181 participants were included in this analysis, 72 (40%) had moderate to severe DD. A model including age, sex, BNP, body mass index, history of atrial fibrillation, coronary artery disease, diabetes mellitus, hypertension and left atrial volume was highly predictive of moderate to severe DD; AUC 0.81 (0.73-0.88; p b 0.0001). Similarly, substitution of BNP with NT-proBNP resulted in an AUC 0.79 (0.72-0.87; p b 0.0001). In these models; BNP N 100 pg/ml (OR 6.24 CI 2.42-16.09, p = 0.0002), history of diabetes (OR 3.52 CI 1. 43-8.70, p = 0.006) and NT-proBNP N 600 pg/ml , p = 0.0004), history of diabetes mellitus (OR 2.75 CI 1.12-6.76, p = 0.03) respectively remained independent predictors of DD in HF-PLEF. Conclusions: Natriuretic peptides were the strongest independent predictors of DD, as determined by Doppler-echocardiography, in HF-PLEF.

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The N-terminal Pro-BNP Investigation of Dyspnea in the Emergency department (PRIDE) study

Cited by 1,092 publications

References 24 publications

Comparative accuracy of NT‐proBNP and MR‐proANP for the diagnosis of acute heart failure in dyspnoeic patients

Comparative accuracy of NT‐proBNP and MR‐proANP for the diagnosis of acute heart failure in dyspnoeic patients

Obesity paradox in heart failure: a heavy matter

BNP and NT‐proBNP predict echocardiographic severity of diastolic dysfunction

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