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Accuracy of N-terminal-pro-atrial natriuretic peptide in patients admitted to emergency department.

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Gruson, Damien [UCL] Rousseau, Michel [UCL] Ahn, Sylvia [UCL] Vanlinden, François [UCL] Thys, Frédéric [UCL] Ketelslegers, Jean-Marie [UCL] Verschuren, Franck [UCL]

OBJECTIVE: B-type natriuretic peptide (BNP) and N-terminal-pro-BNP (Nt-proBNP) are commonly used for the triage of patients in the emergency department (ED) with dyspnoea and/or chest pain. The aim of our study was to determine the accuracy of N-terminal-pro-ANP (Nt-proANP) in such patients. MATERIAL AND METHODS: Nt-proANP was measured by home-made radioimmunoassay in 137 ED patients admitted with cardiovascular and/or pulmonary disorders. BNP and Nt-pro-BNP were determined with automated assays. Final diagnosis was confirmed at discharge or after follow-up. RESULTS: Nt-proANP levels were significantly influenced by the diagnostic subgroups (ANOVA: p<0.001) and were [geometric mean (range)]: 19727 ng/L (5260-45200) in congestive heart failure (CHF, n=31), 6575 ng/L (1350-36000) in coronary artery disease (CAD, n=19), 5324 ng/L (1710-13150) in pulmonary embolism (PE, n=20), 5035 ng/L (1510-16600) in pulmonary diseases (PD, n=24) and 3001 ng/L (750-11860) in patients without cardiopulmonary diseases (n=43). Pairwise comparisons demonstrated that CHF patients had Nt-pro-ANP values higher than all other groups (p<0.05) and that patients without cardiopulmonary diseases had the lowest values (p<0.05). For diagnosis of CHF, the area under the ROC curve of Nt-proANP was 0.94 (95 % CI: 0.89-0.98) and was equivalent to Nt-proBNP (0.91; p=0.284) and BNP (0.93; p=0.572). CONCLUSIONS: The diagnostic accuracy of Nt-proANP was equivalent to BNP and Nt-proBNP in the present cohort of patients admitted to ED with dyspnoea and/or chest pain.

Document type Article de périodique (Journal article) – Journal Article
Access type Accès restreint
Publication date 2008
Journal information "Scandinavian journal of clinical and laboratory investigation" - Vol. 68, no. 5, p. 410-414 (2008)
Peer reviewed yes
issn 0036-5513
Publication status Publié
Affiliations UCL - MD/MINT - Département de médecine interne
UCL - (SLuc) Service d'endocrinologie et de nutrition
UCL - (SLuc) Service de cardiologie
UCL - (SLuc) Service des urgences
MESH Subject Aged ; Cardiovascular Diseases - blood ; Emergency Medical Services ; Female ; Humans ; Lung Diseases - blood ; Male ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; ROC Curve ; Radioimmunoassay ; Sensitivity and Specificity
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Bibliographic reference Gruson, Damien ; Rousseau, Michel ; Ahn, Sylvia ; Vanlinden, François ; Thys, Frédéric ; et. al. Accuracy of N-terminal-pro-atrial natriuretic peptide in patients admitted to emergency department.. In: Scandinavian journal of clinical and laboratory investigation, Vol. 68, no. 5, p. 410-414 (2008)
Permanent URL http://hdl.handle.net/2078.1/26092