International Journal of Cardiology
Volume 135, Issue 2 , Pages 165-174 , 26 June 2009

Diagnostic performance and cost effectiveness of measurements of plasma N-terminal pro brain natriuretic peptide in patients presenting with acute dyspnea or peripheral edema

  • Michael Behnes

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • MBe and MBr contributed equally to this study.
    • ,
  • Martina Brueckmann

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • MBe and MBr contributed equally to this study.
    • ,
  • Parviz Ahmad-Nejad

      Affiliations

    • Institute for Clinical Chemistry, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Siegfried Lang

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Christian Wolpert

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Elif Elmas

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Thorsten Kaelsch

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Joachim Gruettner

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Christel Weiβ

      Affiliations

    • Department for Statistical Analysis, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Martin Borggrefe

      Affiliations

    • First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • ,
  • Michael Neumaier

      Affiliations

    • Institute for Clinical Chemistry, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
    • Corresponding Author InformationCorresponding author. Institute for Clinical Chemistry, Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Tel.: +49 621 383 2222.

Received 12 January 2008 ,Accepted 6 March 2008.

References 

  1. Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics—2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113:e85–e151
  2. Swedberg K, Cleland J, Dargie H, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J. 2005;26:1115–1140
  3. The Federal Health Monitoring of the Federal Ministry of Health-Federal Republic of Germany. http://www.gbe-bund.de. Search pathway: Expenditures, costs and financing - expenditures for specific diseases - tables - cost of illness by facility and sex - diseases of the circulatory system - other forms of heart disease - heart failure (I50) - Select hospitals.
  4. McCullough PA, Nowak RM, McCord J, et al. B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study. Circulation. 2002;106:416–422
  5. Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347:161–167
  6. Januzzi JL, Camargo CA, Anwaruddin S, et al. The N-terminal Pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. Am J Cardiol. 2005;95:948–954
  7. Maisel A, Hollander JE, Guss D, et al. Primary results of the Rapid Emergency Department Heart Failure Outpatient Trial (REDHOT). A multicenter study of B-type natriuretic peptide levels, emergency department decision making, and outcomes in patients presenting with shortness of breath. J Am Coll Cardiol. 2004;44:1328–1333
  8. Morrison LK, Harrison A, Krishnaswamy P, Kazanegra R, Clopton P, Maisel A. Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea. Am Coll Cardiol. 2002;39:202–209
  9. Nielsen LS, Svanegaard J, Klitgaard NA, Egeblad H. N-terminal pro-brain natriuretic peptide for discriminating between cardiac and non-cardiac dyspnoea. Eur J Heart Fail. 2004;6:63–70
  10. Mueller C, Scholer A, Laule-Kilian K, et al. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med. 2004;350:647–654
  11. Mueller C, Laule-Kilian K, Schindler C, et al. Cost-effectiveness of B-type natriuretic peptide testing in patients with acute dyspnea. Arch Intern Med. 2006;166:1081–1087
  12. Nielsen OW, McDonagh TA, Robb SD, Dargie HJ. Retrospective analysis of the cost effectiveness of using plasma brain natriuretic peptide in screening for left ventricular systolic dysfunction in the general population. J Am Coll Cardiol. 2003;41:113–120
  13. Heidenreich PA, Gubens MA, Fonarow GC, Konstam MA, Stevenson LW, Shekelle PG. Cost-effectiveness of screening with B-type natriuretic peptide to identify patients with reduced left ventricular ejection fraction. J Am Coll Cardiol. 2004;43:1019–1026
  14. Siebert U, Januzzi JL, Beinfeld MT, Cameron R, Gazelle GS. Cost-effectiveness of using N-terminal pro-brain natriuretic peptide to guide the diagnostic assessment and management of dyspneic patients in the emergency department. Am J Cardiol. 2006;98:800–805
  15. Nieminen MS, Böhm M, Cowie MR, et al. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J. 2005;26(4):384–416
  16. Di Serio F, Ruggieri V, Varraso L, De Sario R, Mastrorilli A, Pansini N. Analytical evaluation of the Dade Behring Dimension RxL automated N-Terminal proBNP (NT-proBNP) method and comparison with the Roche Elecsys 2010. Clin Chem Lab Med. 2005;43:1263–1273
  17. Mueller C, Breidthardt T, Laule-Kilian K, Christ M, Perruchoud A. The integration of BNP and NT-proBNP into clinical medicine. Swiss Med Wkly. 2007;137:4–12
  18. Schwam E. Rapid measurement of B-type natriuretic peptides reduced time to discharge and treatment costs in patients with acute dyspnea. ACP J Club. 2005;142:A14
  19. Hohl CM, Mitelman BY, Wyer P, Lang E. Should emergency phycicians use B-type natriuretic peptide testing in patients with unexplained dyspnea?. Can J Emerg Med. 2003;5:162–165
  20. Lainchbury JG, Campbell E, Frampton CM, Yandle TG, Nicholls MG, Richards AM. Brain natriuretic peptide and n-terminal brain natriuretic peptide in the diagnosis of heart failure in patients with acute shortness of breath. J Am Coll Cardiol. 2003;42:728–735
  21. Bayés-Genís Antoni, Santaló-Bel Miquel, Zapico-Muñiz Edgar, et al. N-terminal probrain natriuretic peptide (NT-proBNP) in the emergency diagnosis and in-hospital monitoring of patients with dyspnoea and ventricular dysfunction. Eur J Heart Fail. 2004;6:301–308
  22. Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006;27:330–337
  23. Vasan RS, Benjamin EJ, Larson MG, et al. Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham heart study. JAMA. 2002;288:1252–1259
  24. Redfield MM, Rodeheffer RJ, Jacobsen SJ, Mahoney DW, Bailey KR, Burnett JC. Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study. Circulation. 2004;109:3176–3181
  25. Anand IS, Fisher LD, Chiang YT, et al. Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial (Val-HeFT). Circulation. 2003;107:1278–1283
  26. Troughton RW, Frampton CM, Yandle TG, Espiner EA, Nicholls MG, Richards AM. Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations. Lancet. 2000;355:1126–1130
  27. Jourdain P, Jondeau G, Funck F, et al. Plasma brain natriuretic peptide-guided therapy to improve outcome in heart failure: the STARS-BNP Multicenter Study. J Am Coll Cardiol. 2007;49:1733–1739
  28. Wright SP, Doughty RN, Pearl A, et al. Plasma amino-terminal pro-brain natriuretic peptide and accuracy of heart-failure diagnosis in primary care: a randomized, controlled trial. J Am Coll Cardiol. 2003;42:1793–1800
  29. Mark DB, Felker GM. B-type natriuretic peptide — a biomarker for all seasons?. N Engl J Med. 2004;350:718–720
  30. Schuenemann HJ, Akl E. Rapid measurement of B-type natriuretic peptides reduced time to discharge and treatment costs in patients with acute dyspnea. ACP J Club. 2004;141:35
  31. Apple FS, Murakami MM, Pearce LA, Herzog CA. Multi-biomarker risk stratification of N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and cardiac troponin T and I in end-stage renal disease for all-cause death. Clin Chem. 2004;50:2279–2285
  32. Anwaruddin S, Lloyd-Jones DM, Baggish A, et al. Renal function, congestive heart failure, and amino-terminal pro-brain natriuretic peptide measurement: results from the ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) Study. J Am Coll Cardiol. 2006;47:91–97
  33. Kucher N, Printzen G, Goldhaber SZ. Prognostic role of brain natriuretic peptide in acute pulmonary embolism. Circulation. 2003;107:2545–2547
  34. Kucher N, Printzen G, Doernhoefer T, Windecker S, Meier B, Hess OM. Low pro-brain natriuretic peptide levels predict benign clinical outcome in acute pulmonary embolism. Circulation. 2003;107:1576–1578
  35. Brueckmann M, Huhle G, Lang S, et al. Prognostic value of plasma N-terminal pro-brain natriuretic peptide in patients with severe sepsis. Circulation. 2005;112:527–534
  36. Hohl CM. Should natriuretic peptide testing be incorporated into emergency medicine practice?. Can J Emerg Med. 2006;8:259–261

☆ This work was supported by a grant of the Faculty of Medicine Mannheim, University of Heidelberg, Germany, and through support by Dade Behring, Germany.

PII: S0167-5273(08)00510-X

doi: 10.1016/j.ijcard.2008.03.045

International Journal of Cardiology
Volume 135, Issue 2 , Pages 165-174 , 26 June 2009

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