دورية أكاديمية
Diagnostic properties of natriuretic peptides and opportunities for personalized thresholds for detecting heart failure in primary care.
العنوان: | Diagnostic properties of natriuretic peptides and opportunities for personalized thresholds for detecting heart failure in primary care. |
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المؤلفون: | Harskamp RE; Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, The Netherlands., De Clercq L; Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Veelers L; Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands., Schut MC; Department of Laboratory Medicine, Translational AI. Amsterdam UMC, Amsterdam, The Netherlands., van Weert HCPM; Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands., Handoko ML; Department of Cardiology, Amsterdam UMC Location VU University, Amsterdam, The Netherlands.; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, The Netherlands., Moll van Charante EP; Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Himmelreich JCL; Department of General Practice, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, The Netherlands. |
المصدر: | Diagnosis (Berlin, Germany) [Diagnosis (Berl)] 2023 Sep 05; Vol. 10 (4), pp. 432-439. Date of Electronic Publication: 2023 Sep 05 (Print Publication: 2023). |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: de Gruyter Country of Publication: Germany NLM ID: 101654734 Publication Model: eCollection Cited Medium: Internet ISSN: 2194-802X (Electronic) Linking ISSN: 2194802X NLM ISO Abbreviation: Diagnosis (Berl) Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Berlin ; Boston : de Gruyter, [2014]- |
مواضيع طبية MeSH: | Natriuretic Peptide, Brain* , Heart Failure*/diagnosis, Humans ; Retrospective Studies ; Natriuretic Peptides ; Sensitivity and Specificity ; Primary Health Care |
مستخلص: | Objectives: Heart failure (HF) is a prevalent syndrome with considerable disease burden, healthcare utilization and costs. Timely diagnosis is essential to improve outcomes. This study aimed to compare the diagnostic performance of B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) in detecting HF in primary care. Our second aim was to explore if personalized thresholds (using age, sex, or other readily available parameters) would further improve diagnostic accuracy over universal thresholds. Methods: A retrospective study was performed among patients without prior HF who underwent natriuretic peptide (NP) testing in the Amsterdam General Practice Network between January 2011 and December 2021. HF incidence was based on registration out to 90 days after NP testing. Diagnostic accuracy was evaluated with AUROC, sensitivity and specificity based on guideline-recommended thresholds (125 ng/L for NT-proBNP and 35 ng/L for BNP). We used inverse probability of treatment weighting to adjust for confounding. Results: A total of 15,234 patients underwent NP testing, 6,870 with BNP (4.5 % had HF), and 8,364 with NT-proBNP (5.7 % had HF). NT-proBNP was more accurate than BNP, with an AUROC of 89.9 % (95 % CI: 88.4-91.2) vs. 85.9 % (95 % CI 83.5-88.2), with higher sensitivity (95.3 vs. 89.7 %) and specificity (59.1 vs. 58.0 %). Differentiating NP cut-off by clinical variables modestly improved diagnostic accuracy for BNP and NT-proBNP compared with a universal threshold. Conclusions: NT-proBNP outperforms BNP for detecting HF in primary care. Personalized instead of universal diagnostic thresholds led to modest improvement. (© 2023 the author(s), published by De Gruyter, Berlin/Boston.) |
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فهرسة مساهمة: | Keywords: biomarker; cardiovascular medicine; diagnostics; heart failure |
المشرفين على المادة: | 114471-18-0 (Natriuretic Peptide, Brain) 0 (Natriuretic Peptides) |
تواريخ الأحداث: | Date Created: 20230905 Date Completed: 20231129 Latest Revision: 20231129 |
رمز التحديث: | 20231130 |
DOI: | 10.1515/dx-2023-0089 |
PMID: | 37667563 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2194-802X |
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DOI: | 10.1515/dx-2023-0089 |