B-Type Natriuretic Peptide to Rule out Heart Failure: Different Cutoffs for Different Patients?

Adjusting BNP thresholds for clinical covariates improved the test's ability to differentiate between cardiac and noncardiac causes of dyspnea.

B-type natriuretic peptide levels are frequently used to distinguish cardiac from noncardiac etiologies of dyspnea. However, patient characteristics other than heart failure can affect BNP levels. To determine how, investigators at a single Veterans Affairs Medical Center performed a retrospective analysis of BNP assays obtained from 335 men presenting to the emergency department with dyspnea in 2007. Four physicians who were blinded to BNP results reviewed charts to adjudicate diagnoses.

Age, body-mass index, atrial fibrillation, and creatinine level were independently associated with altered BNP levels. The authors determined the BNP cutoff values that produced a sensitivity of 91% (the sensitivity in the entire cohort of the conventional …

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

B-Type Natriuretic Peptide to Rule out Heart Failure: Different Cutoffs for Different Patients?

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Reviewing Author