Valor del nivel de NTproBNP en población adulta extrahospitalaria

Aguilar, Juan Cosín; Martínez, Amparo Hernándiz; Gil, José Luis Díez; Carbonell, Carmen Capdevila; Sanz, Antonio Salvador; Torrent, José Luis Diago; Otero, M. Rivera; Serrano, Rafael Payá; Martínez, Vicente Bertoméu; Garri, Francisco Sogorb; Torrent, Alejandro Jordán; Latorre, Luis Mainar; Jornet, Guillermo Grau; Llinares, Segundo Martí; Palau, Vicente Miró

doi:10.1016/s0300-8932(03)76859-6

Cited by 11 publications

(6 citation statements)

References 30 publications

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“…From 3131 records ( Figure 1 ), 24 studies presented accuracy data for NP screening to detect LVSD, involving 26 565 participants 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ; all included studies were cross‐sectional. The included studies, with population characteristics and the lowest threshold reported, are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies included data on only high‐risk populations, 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 12 included only general populations, 37 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 and four included data on high‐risk and general populations. 51 , 52 , 53 , 54 Nine studies assessed NT‐proBNP only, 32 , 33 , 34 , 40 , 43 , 46 , 47 , 51 , 54 and nine studies assessed BNP only; one of these used a point‐of‐care BNP test, Biosite®, 35 whereas all other tests were processed in a laboratory. Six studies evaluated performance in both biomarkers.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies evaluated performance in both biomarkers. 37 , 39 , 42 , 43 , 48 , 52 All studies used echocardiography as the comparator except one that used cardiac MRI. 45 Subgroup sample sizes corresponding to each meta‐analysis were smaller for high‐risk populations with NT‐proBNP ( n = 4193) and BNP ( n = 2940), with larger groups seen in the general populations, with NT‐proBNP ( n = 13 416) and BNP ( n = 12 970).…”

Section: Resultsmentioning

confidence: 99%

“… 45 Two studies described participants as having a high proportion of symptomatic participants 35 , 39 and one study recording only 22.2% as symptomatic. 43 …”

Section: Resultsmentioning

confidence: 99%

“…Nine studies assessed NT‐proBNP only, 32–34,40,43,46,47,51,54 and nine studies assessed BNP only; one of these used a point‐of‐care BNP test, Biosite®, 35 whereas all other tests were processed in a laboratory. Six studies evaluated performance in both biomarkers 37,39,42,43,48,52 . All studies used echocardiography as the comparator except one that used cardiac MRI 45 .…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic accuracy of natriuretic peptide screening for left ventricular systolic dysfunction in the community: systematic review and meta‐analysis

et al. 2023

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Aims Heart failure (HF) is a global health burden and new strategies to achieve timely diagnosis and early intervention are urgently needed. Natriuretic peptide (NP) testing can be used to screen for left ventricular systolic dysfunction (LVSD), but evidence on test performance is mixed, and international HF guidelines differ in their recommendations. Our aim was to summarize the evidence on diagnostic accuracy of NP screening for LVSD in general and high-risk community populations and estimate optimal screening thresholds. Methods We searched relevant databases up to August 2020 for studies with a screened community population of over 100 adults reporting NP performance to diagnose LVSD. Study inclusion, quality assessment, and data extraction were conducted independently and in duplicate. Diagnostic test meta-analysis used hierarchical summary receiver operating characteristic curves to obtain estimates of pooled accuracy to detect LVSD, with optimal thresholds obtained to maximize the sum of sensitivity and specificity. Results Twenty-four studies were identified, involving 26 565 participants: eight studies in high-risk populations (at least one cardiovascular risk factor), 12 studies in general populations, and four in both high-risk and general populations combined. For detecting LVSD in screened high-risk populations with N-terminal prohormone brain natriuretic peptide (NT-proBNP), the pooled sensitivity was 0.87 [95% confidence interval (CI) 0.73-0.94] and specificity 0.84 (95% CI 0.55-0.96); for BNP, sensitivity was 0.75 (95% CI 0.65-0.83) and specificity 0.78 (95% CI 0.72-0.84). Heterogeneity between studies was high with variations in positivity threshold. Due to a paucity of high-risk studies that assessed NP performance at multiple thresholds, it was not possible to calculate optimal thresholds for LVSD screening in high-risk populations alone. To provide an indication of where the positivity threshold might lie, the pooled accuracy for LVSD screening in high-risk and general community populations were combined and gave an optimal cut-off of 311 pg/mL [sensitivity 0.74 (95% CI 0.53-0.88), specificity 0.85 (95% CI 0.68-0.93)] for NT-proBNP and 49 pg/mL [sensitivity 0.68 (95% CI 0.45-0.85), specificity 0.81 (0.67-0.90)] for BNP. Conclusions Our findings suggest that in high-risk community populations NP screening may accurately detect LVSD, potentially providing an important opportunity for diagnosis and early intervention. Our study highlights an urgent need for further prospective studies, as well as an individual participant data meta-analysis, to more precisely evaluate diagnostic accuracy and identify optimal screening thresholds in specifically defined community-based populations to inform future guideline recommendations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“… 45 Two studies described participants as having a high proportion of symptomatic participants 35 , 39 and one study recording only 22.2% as symptomatic. 43 …”

Section: Resultsmentioning

confidence: 99%