Mid-regional pro-atrial natriuretic peptide (MR-proANP) testing for the diagnostic and prognostic evaluation of patients with acute dyspnea due to heart failure and pneumonia
Các tác giả
Từ khóa:
chẩn đoán, tiên lượng, MR-proANP, suy tim cấp, viêm phổiTóm tắt
Purposes: The purpose of this study was to evaluate the diagnostic and prognostic value of mid-regional pro-atrial natriuretic peptide (MR-proANP) for the evaluation of patients presenting to the emergency department with acute dyspnea. Methods: We prospectively evaluated MR-proANP in consecutive patients presenting with acute dyspnea in a medical emergency unit during a 30-day period. This biomarker was tested for its potential to predict diagnoses and survival. Results: Overall, n = 230 patients were included. Of these, 67.4% had acute heart failure, 32.6% had pneumonia, and 4.7% died. The level of MR-proANP was the highest in patients with acute heart failure. NYHA scores and levels of MR-proANP correlated positively. MR-proANP achieved an AUC of 0.93 for the diagnosis of acute heart failure. Using a cut-off of 153 pmol/L, sensitivity was 93% and specificity 85%. PPV was 93% and NPV 86.5%. In time-dependent analyses, MR-proANP had a high AUC for death during the first month. Just only mid-regional peptide was independently prognostic and reclassified risk at one month [MR-proANP, hazard ratio (HR) =10.87]. Conclusion: Among patients with acute dysponea, MR-proANP is not only accurate for diagnosis of acute heart failure, but also independently prognostic to 1 month of the follow-up.
Abstract
Purposes: The purpose of this study was to evaluate the diagnostic and prognostic value of mid-regional pro-atrial natriuretic peptide (MR-proANP) for the evaluation of patients presenting to the emergency department with acute dyspnea. Methods: We prospectively evaluated MR-proANP in consecutive patients presenting with acute dyspnea in a medical emergency unit during a 30-day period. This biomarker was tested for its potential to predict diagnoses and survival. Results: Overall, n = 230 patients were included. Of these, 67.4% had acute heart failure, 32.6% had pneumonia, and 4.7% died. The level of MR-proANP was the highest in patients with acute heart failure. NYHA scores and levels of MR-proANP correlated positively. MR-proANP achieved an AUC of 0.93 for the diagnosis of acute heart failure. Using a cut-off of 153 pmol/L, sensitivity was 93% and specificity 85%. PPV was 93% and NPV 86.5%. In time-dependent analyses, MR-proANP had a high AUC for death during the first month. Just only mid-regional peptide was independently prognostic and reclassified risk at one month [MR-proANP, hazard ratio (HR) =10.87]. Conclusion: Among patients with acute dysponea, MR-proANP is not only accurate for diagnosis of acute heart failure, but also independently prognostic to 1 month of the follow-up.
Tài liệu tham khảo
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