NT-proBNP cut-off value for ruling out heart failure in atrial fibrillation patients - A prospective clinical study.
Am J Emerg Med
; 71: 18-24, 2023 09.
Article
em En
| MEDLINE
| ID: mdl-37320999
ABSTRACT
STUDY OBJECTIVE:
N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements can be used to rule out heart failure in patients with sinus rhythm. Atrial fibrillation often coexists with heart failure but affects NT-proBNP levels. This study aims to identify the optimal NT-proBNP cut-off value for ruling out heart failure among atrial fibrillation patients.METHODS:
This prospective study included 409 atrial fibrillation patients admitted to the emergency department. The inclusion criterion was documented atrial fibrillation on a 12lead electrocardiogram. All patients completed a NT-proBNP blood sample, a chest X-ray and an echocardiogram. Heart failure was defined as a left ventricular ejection fraction of <40%.RESULTS:
In total, 409 patients were included (mean age 75.2 ± 11.6). The median NT-proBNP level was 2577 ng/L (quartiles 1185-5438) and 21% had heart failure. We found a lower median NT proBNP level of 3187 ± 3973 ng/L in patients without heart failure compared to 9254 ± 8008 ng/L in patients with heart failure (absolute difference 4131, 95% (CI) 3299-4986, p < 0.001). The area under the receiver operating characteristic curve for diagnosing heart failure was 0.82 (95% confidence interval 0.77-0.87). The optimal cut-off value for ruling out heart failure was 739 ng/L with a sensitivity of 99%, a specificity of 18%, and a negative predictive value of 98%.CONCLUSIONS:
NT-proBNP can be used to rule out heart failure in atrial fibrillation patients with a high negative predictive value, but low specificity. TRIAL REGISTRATION NUMBER NCT04125966. https//clinicaltrials.gov/ct2/show/NCT04125966.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Insuficiência Cardíaca
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Humans
/
Middle aged
Idioma:
En
Revista:
Am J Emerg Med
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Dinamarca