دورية أكاديمية
أعرض في EDS

Diagnostic properties of natriuretic peptides and opportunities for personalized thresholds for detecting heart failure in primary care.

التفاصيل البيبلوغرافية
العنوان: Diagnostic properties of natriuretic peptides and opportunities for personalized thresholds for detecting heart failure in primary care.
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.)
References: McDonagh, TA, Metra, M, Adamo, M, Gardner, RS, Baumbach, A, Böhm, M, et al.. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2021;42:3599–726. https://doi.org/10.1093/eurheartj/ehab368 . (PMID: 10.1093/eurheartj/ehab368)
Bragazzi, NL, Zhong, W, Shu, J, Abu Much, A, Lotan, D, Grupper, A, et al.. Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017. Eur J Prev Cardiol 2021;28:1682–90. https://doi.org/10.1093/eurjpc/zwaa147 . (PMID: 10.1093/eurjpc/zwaa147)
NIVEL . Jaarcijfers aandoeningen – Huisartsenregistraties . NIVEL Zorgregistraties Eerste Lijn; 2022. www.nivel.nl2022 .
Taylor, CJ, Ordóñez-Mena, JM, Roalfe, AK, Lay-Flurrie, S, Jones, NR, Marshall, T, et al.. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000–2017: population based cohort study. BMJ 2019;364:l223. https://doi.org/10.1136/bmj.l223 . (PMID: 10.1136/bmj.l223)
Riedinger, MS, Dracup, KA, Brecht, ML, SOLVD Investigatos, Studies of Left Ventricular Dysfunction . Quality of life in women with heart failure, normative groups, and patients with other chronic conditions. Am J Crit Care 2002;11:211–9.
De Boer, RA, Dieleman-Bij de Vaate, AJIL, Lambermon, HMM, Oud, M, Rutten, FH, Schaafstra, A, et al.. NHG-standaard Hartfalen (2021) . Utrecht: Nederlands Huisartsen Genootschap; 2021. https://richtlijnen.nhg.org/standaarden/hartfalen .
Madamanchi, C, Alhosaini, H, Sumida, A, Runge, MS. Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure. Int J Cardiol 2014;176:611–7. https://doi.org/10.1016/j.ijcard.2014.08.007 . (PMID: 10.1016/j.ijcard.2014.08.007)
Takase, H, Dohi, Y. Kidney function crucially affects B-type natriuretic peptide (BNP), N-terminal proBNP and their relationship. Eur J Clin Invest 2014;44:303–8. https://doi.org/10.1111/eci.12234 . (PMID: 10.1111/eci.12234)
Keyzer, JM, Hoffmann, JJ, Ringoir, L, Nabbe, KC, Widdershoven, JW, Pop, VJ. Age- and gender-specific brain natriuretic peptide (BNP) reference ranges in primary care. Clin Chem Lab Med 2014;52:1341–6. https://doi.org/10.1515/cclm-2013-0791 . (PMID: 10.1515/cclm-2013-0791)
Bossuyt, PM, Reitsma, JB, Bruns, DE, Gatsonis, CA, Glasziou, PP, Irwig, L, et al.. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ 2015;351:h5527. https://doi.org/10.1148/radiol.2015151516 . (PMID: 10.1148/radiol.2015151516)
Poortvliet, MC, Lamkaddem, M, Devillé, W. Niet op naam ingeschreven (NONI) bij de huisarts: Inventarisatie en gevolgen voor de ziekenfondsverzekerden . Utrecht: NIVEL; 2005.
National Institute for Health and Care Excellence (NICE) . Guidline [NG106]. Chronic heart failure in adults: diagnosis and management. 2018. https://www.nice.org.uk/guidance/ng106.
De Clercq, L, Schut, MC, Bossuyt, PMM, van Weert, H, Handoko, ML, Harskamp, RE. TARGET-HF: developing a model for detecting incident heart failure among symptomatic patients in general practice using routine health care data. Fam Pract 2022. https://doi.org/10.1093/fampra/cmac069 . (PMID: 10.1093/fampra/cmac069)
Taylor, CJ, Roalfe, AK, Iles, R, Hobbs, FR, investigators, R, Barton, P, et al.. Primary care REFerral for EchocaRdiogram (REFER) in heart failure: a diagnostic accuracy study. Br J Gen Pract 2017;67:e94–102. https://doi.org/10.3399/bjgp16x688393 . (PMID: 10.3399/bjgp16x688393)
Agarwal, SK, Chambless, LE, Ballantyne, CM, Astor, B, Bertoni, AG, Chang, PP, et al.. Prediction of incident heart failure in general practice: the Atherosclerosis Risk in Communities (ARIC) study. Circ Heart Fail 2012;5:422–9. https://doi.org/10.1161/circheartfailure.111.964841 . (PMID: 10.1161/circheartfailure.111.964841)
Goyal, A, Norton, CR, Thomas, TN, Davis, RL, Butler, J, Ashok, V, et al.. Predictors of incident heart failure in a large insured population: a one million person-year follow-up study. Circ Heart Fail 2010;3:698–705. https://doi.org/10.1161/circheartfailure.110.938175 . (PMID: 10.1161/circheartfailure.110.938175)
Weber, M, Hamm, C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart 2006;92:843–9. https://doi.org/10.1136/hrt.2005.071233 . (PMID: 10.1136/hrt.2005.071233)
Mueller, C, McDonald, K, de Boer, RA, Maisel, A, Cleland, JGF, Kozhuharov, N, et al.. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. Eur J Heart Fail 2019;21:715–31. https://doi.org/10.1002/ejhf.1494 . (PMID: 10.1002/ejhf.1494)
Redfield, MM, Rodeheffer, RJ, Jacobsen, SJ, Mahoney, DW, Bailey, KR, Burnett, JCJr. Plasma brain natriuretic peptide concentration: impact of age and gender. J Am Coll Cardiol 2002;40:976–82. https://doi.org/10.1016/s0735-1097(02)02059-4 . (PMID: 10.1016/s0735-1097(02)02059-4)
Wang, TJ, Larson, MG, Levy, D, Benjamin, EJ, Leip, EP, Wilson, PW, et al.. Impact of obesity on plasma natriuretic peptide levels. Circulation 2004;109:594–600. https://doi.org/10.1161/01.cir.0000112582.16683.ea . (PMID: 10.1161/01.cir.0000112582.16683.ea)
Richards, M, Di Somma, S, Mueller, C, Nowak, R, Peacock, WF, Ponikowski, P, et al.. Atrial fibrillation impairs the diagnostic performance of cardiac natriuretic peptides in dyspneic patients: results from the BACH study (Biomarkers in ACute Heart Failure). JACC Heart Fail 2013;1:192–9. https://doi.org/10.1016/j.jchf.2013.02.004 . (PMID: 10.1016/j.jchf.2013.02.004)
Rivera, M, Taléns-Visconti, R, Salvador, A, Bertomeu, V, Miró, V, García de Burgos, F, et al.. NT-proBNP levels and hypertension. Their importance in the diagnosis of heart failure. Rev Española Cardiol 2004;57:396–402. https://doi.org/10.1016/s1885-5857(06)60170-9 . (PMID: 10.1016/s1885-5857(06)60170-9)
Bergler-Klein, J, Gyöngyösi, M, Maurer, G. The role of biomarkers in valvular heart disease: focus on natriuretic peptides. Can J Cardiol 2014;30:1027–34. https://doi.org/10.1016/j.cjca.2014.07.014 . (PMID: 10.1016/j.cjca.2014.07.014)
Natriuretic Peptides Studies Collaboration . Natriuretic peptides and integrated risk assessment for cardiovascular disease: an individual-participant-data meta-analysis. Lancet Diabetes Endocrinol 2016;4:840–9. https://doi.org/10.1016/s2213-8587(16)30196-6 . (PMID: 10.1016/s2213-8587(16)30196-6)
Yang, H, Negishi, K, Otahal, P, Marwick, TH. Clinical prediction of incident heart failure risk: a systematic review and meta-analysis. Open Heart 2015;2:e000222. https://doi.org/10.1136/openhrt-2014-000222 . (PMID: 10.1136/openhrt-2014-000222)
Ozenne, B, Subtil, F, Maucort-Boulch, D. The precision--recall curve overcame the optimism of the receiver operating characteristic curve in rare diseases. J Clin Epidemiol 2015;68:855–9. https://doi.org/10.1016/j.jclinepi.2015.02.010 . (PMID: 10.1016/j.jclinepi.2015.02.010)
Nahm, FS. Receiver operating characteristic curve: overview and practical use for clinicians. Korean J Anesthesiol 2022;75:25–36. https://doi.org/10.4097/kja.21209 . (PMID: 10.4097/kja.21209)
Austin, PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res 2011;46:399–424. https://doi.org/10.1080/00273171.2011.568786 . (PMID: 10.1080/00273171.2011.568786)
Bonferroni, C. Teoria statistica delle classi e calcolo delle probabilita . Firenze: Pubblicazioni del R Istituto Superiore di Scienze Economiche e Commericiali di Firenze; 1936, 8:3–62 pp.
Pedregosa, F, Varoquaux, G, Gramfort, A, Michel, V, Thirion, B, Grisel, O, et al.. Scikit-learn: machine learning in Python. J Mach Learn Res 2011;12:2825–30.
Ewald, B, Ewald, D, Thakkinstian, A, Attia, J. Meta-analysis of B type natriuretic peptide and N-terminal pro B natriuretic peptide in the diagnosis of clinical heart failure and population screening for left ventricular systolic dysfunction. Intern Med J 2008;38:101–13. https://doi.org/10.1111/j.1445-5994.2007.01454.x . (PMID: 10.1111/j.1445-5994.2007.01454.x)
Balion, C, Santaguida, PL, Hill, S, Worster, A, McQueen, M, Oremus, M, et al.. Testing for BNP and NT-proBNP in the diagnosis and prognosis of heart failure. Evid Rep Technol Assess 2006;142:1–147.
Clerico, A, Fontana, M, Zyw, L, Passino, C, Emdin, M. Comparison of the diagnostic accuracy of brain natriuretic peptide (BNP) and the N-terminal part of the propeptide of BNP immunoassays in chronic and acute heart failure: a systematic review. Clin Chem 2007;53:813–22. https://doi.org/10.1373/clinchem.2006.075713 . (PMID: 10.1373/clinchem.2006.075713)
Booth, RA, Hill, SA, Don-Wauchope, A, Santaguida, PL, Oremus, M, McKelvie, R, et al.. Performance of BNP and NT-proBNP for diagnosis of heart failure in primary care patients: a systematic review. Heart Fail Rev 2014;19:439–51. https://doi.org/10.1007/s10741-014-9445-8 . (PMID: 10.1007/s10741-014-9445-8)
Ontario Health (Quality) . Use of B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) as diagnostic tests in adults with suspected heart failure: a health technology assessment. Ont Health Technol Assess Ser 2021;21:1–125.
Clerico, A, Carlo Zucchelli, G, Pilo, A, Passino, C, Emdin, M. Clinical relevance of biological variation: the lesson of brain natriuretic peptide (BNP) and NT-proBNP assay. Clin Chem Lab Med 2006;44:366–78. https://doi.org/10.1515/cclm.2006.063 . (PMID: 10.1515/cclm.2006.063)
Clerico, A, Franzini, M, Masotti, S, Prontera, C, Passino, C. State of the art of immunoassay methods for B-type natriuretic peptides: an update. Crit Rev Clin Lab Sci 2015;52:56–69. https://doi.org/10.3109/10408363.2014.987720 . (PMID: 10.3109/10408363.2014.987720)
Mant, J, Doust, J, Roalfe, A, Barton, P, Cowie, MR, Glasziou, P, et al.. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technol Assess 2009;13:1–207. https://doi.org/10.3310/hta13320 . (PMID: 10.3310/hta13320)
Hildebrandt, P, Collinson, PO, Doughty, RN, Fuat, A, Gaze, DC, Gustafsson, F, et al.. Age-dependent values of N-terminal pro-B-type natriuretic peptide are superior to a single cut-point for ruling out suspected systolic dysfunction in primary care†. Eur Heart J 2010;31:1881–9. https://doi.org/10.1093/eurheartj/ehq163 . (PMID: 10.1093/eurheartj/ehq163)
Cox, E, Martin, BC, Van Staa, T, Garbe, E, Siebert, U, Johnson, ML. Good research practices for comparative effectiveness research: approaches to mitigate bias and confounding in the design of nonrandomized studies of treatment effects using secondary data sources: the International Society for Pharmacoeconomics and Outcomes Research Good Research Practices for Retrospective Database Analysis Task Force Report--part II. Value Health 2009;12:1053–61. https://doi.org/10.1111/j.1524-4733.2009.00601.x . (PMID: 10.1111/j.1524-4733.2009.00601.x)
O’Sullivan, JW, Banerjee, A, Heneghan, C, Pluddemann, A. Verification bias. BMJ Evid Based Med 2018;23:54–5. https://doi.org/10.1136/bmjebm-2018-110919 . (PMID: 10.1136/bmjebm-2018-110919)
Farnsworth, CW, Bailey, AL, Jaffe, AS, Scott, MG. Diagnostic concordance between NT-proBNP and BNP for suspected heart failure. Clin Biochem 2018;59:50–5. https://doi.org/10.1016/j.clinbiochem.2018.07.002 . (PMID: 10.1016/j.clinbiochem.2018.07.002)
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
الوصف
تدمد:2194-802X
DOI:10.1515/dx-2023-0089