BNP for Diagnosis and Management of Emergency Department Patients with Suspected Acute Coronary Syndrome?

Although B-type natriuretic peptide (BNP) has been demonstrated to be a useful diagnostic and prognostic marker for patients with congestive heart failure, it has not been shown to aid management or diagnosis in the emergency department (ED), except in patients who present with dyspnea, for whom acute decompensated heart failure is a consideration. In a prospective study, researchers assessed the association between BNP level and outcome in 348 adult patients who presented to a single ED with symptoms suggestive of acute coronary syndrome, nondiagnostic but detectable troponin levels (0.04 to 0.4 ng/mL), and nondiagnostic electrocardiograms (ECGs).

BNP levels were obtained within 4 hours of presentation; clinicians were blinded to the result…