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Biomarkers. 2016 Sep;21(6):538-43. doi: 10.3109/1354750X.2016.1160427. Epub 2016 Apr 6.

Influence of diabetes on natriuretic peptide thresholds in screening for Stage B heart failure.

Author information

1
a Wellcome-Wolfson Building, Centre for Experimental Medicine , Queen's University Belfast , Belfast , Northern Ireland ;
2
b Chronic Cardiovascular Disease Management Group , St Vincent's University Hospital Healthcare Group , Dublin , Ireland ;
3
c School of Medicine , University College Dublin , Belfield, Dublin , Ireland ;
4
d Department of Endocrinology , St Vincent's University Hospital Healthcare Group , Elm Park, Dublin , Ireland.

Abstract

CONTEXT:

Natriuretic peptide (NP) has been shown to be an effective screening tool to identify patients with Stage B heart failure and to have clinical value in preventing heart failure progression. The impact of associated metabolic confounders on the screening utility of NP needs clarification.

OBJECTIVE:

To assess the impact of diabetes mellitus (DM) on NP screening for asymptomatic Stage B heart failure.

MATERIALS AND METHODS:

The study population consisted of 1368 asymptomatic patients with cardiovascular risk factors recruited from general practice as part of the STOP-HF trial. B-type NP (BNP) was quantified at point-of-care.

RESULTS:

BNP was found to be as accurate for detecting Stage B heart failure in DM patients compared to non-DM patients (AUC 0.75 [0.71,0.78] and 0.77 [0.72,0.82], respectively). However, different BNP thresholds are required to achieve the same level of diagnostic sensitivity in DM compared with non-DM patients. To achieve 80% sensitivity a difference of 5-ng/L lower is required for patients with DM.

CONCLUSION:

Although a significantly different BNP threshold is detected for patients with DM, the BNP concentration difference is small and unlikely to warrant a clinically different diagnostic threshold.

KEYWORDS:

B-type natriuretic peptide; cardiac biomarker; cardiovascular disease; diabetes mellitus; ventricular dysfunction

PMID:
27049231
DOI:
10.3109/1354750X.2016.1160427
[Indexed for MEDLINE]

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