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NT-proBNP as a means of triage for the risk of hospitalisation in primary care.
- Source :
-
European journal of preventive cardiology [Eur J Prev Cardiol] 2012 Feb; Vol. 19 (1), pp. 55-61. Date of Electronic Publication: 2011 Feb 18. - Publication Year :
- 2012
-
Abstract
- Background: In primary care, identification of patients who are at risk of major adverse events is of great importance. At the same time identifying individuals who are at very low risk and do not need further diagnostic workup and therapy is also important and may help to correctly allocate scarce healthcare resources.<br />Aim: This study evaluated amino-terminal pro B-natriuretic peptide (NT-proBNP) as a risk marker in primary care patients with hypertension, diabetes, clinically suspected heart failure (HF), history of coronary artery disease or myocardial infarction.<br />Methods and Results: A prospective observational study was conducted in 1203 primary care patients. The primary endpoint, time to all-cause hospitalisation, was reached in 282 (24%) individuals within 12 months. Of all variables analysed, only NT-proBNP (HR 1.001 [1.000-1.001], p < 0.001) and age (HR 1.018 [1.007-1.028], p = 0.001) were of independent predictive value in a stepwise Cox regression analysis regarding all-cause hospitalisation. Neither systolic dysfunction nor signs and symptoms of HF added independent information to predict outcome. The negative predictive value (NPV) increased depending on the specificity of the endpoint (NPV was 86% for all-cause, 98% for cardiac and 100% for HF-related hospitalisation for 125 pg/ml). Positive predictive value and NPV were superior for NT-proBNP compared to clinical signs and symptoms of HF at every cut-point between 100 and 500 pg/ml.<br />Conclusion: NT-proBNP levels predicted clinical events in primary care patients at risk. NPVs were excellent in this high risk population, proving NT-proBNP measurement a safe diagnostic tool.
- Subjects :
- Aged
Aged, 80 and over
Austria epidemiology
Biomarkers blood
Cardiovascular Agents therapeutic use
Cardiovascular Diseases blood
Cardiovascular Diseases drug therapy
Cardiovascular Diseases mortality
Cardiovascular Diseases physiopathology
Chi-Square Distribution
Female
Humans
Linear Models
Male
Middle Aged
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Cardiovascular Diseases diagnosis
Hospitalization
Mass Screening methods
Natriuretic Peptide, Brain blood
Peptide Fragments blood
Primary Health Care
Triage
Subjects
Details
- Language :
- English
- ISSN :
- 2047-4881
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of preventive cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 21450621
- Full Text :
- https://doi.org/10.1177/1741826710391545