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B-type natriuretic peptides for the diagnosis of congestive heart failure in dyspneic oldest-old patients |
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| Authors: | Chenevier-Gobeaux Camille Delerme Samuel Allo Jean-Christophe Arthaud Martine Claessens Yann-Erick Ekindjian Ohvanesse G Riou Bruno Ray Patrick |
| Affiliation: | a Biochemistry A, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France b Department of Emergency Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France c Department of Emergency Medicine and Surgery, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris (AP-HP), 47-83 boulevard de l'Hôpital, 75013 Paris, Université Pierre et Marie Curie Paris 6, France d Laboratory of Emergency Biology, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris (AP-HP), 47-83 boulevard de l'Hôpital, 75013 Paris, Université Pierre et Marie Curie Paris 6, France |
| Abstract: | ObjectivesTo evaluate the accuracy of B-type natriuretic peptide (BNP) and amino-terminal pro-brain natriuretic peptide (NT-proBNP) for the diagnosis of congestive heart failure (CHF) in dyspneic patients aged ≥ 85 years admitted to the Emergency Department (ED), and to define threshold values in this oldest-old population.Design and methodsThis study involved 210 oldest-old patients, and 360 patients aged from 65 to 84 years (< 85 years), admitted to the ED for dyspnea.ResultsMedian BNP and NT-proBNP levels were significantly higher in CHF oldest-old patients (p < 0.001). BNP and NT-proBNP threshold values were higher in oldest-old patients (290 and 2800 pg/mL, respectively) compared to that of patients < 85 years (270 and 1700 pg/mL, respectively). In a multivariate analysis, both BNP and NT-proBNP were the strongest variables associated with CHF in oldest-old patients. Neither renal function nor gender had impact on the diagnostic utility of the two tests.ConclusionBoth BNP and NT-proBNP could potentially be reliable biomarkers for the diagnosis of CHF in oldest-old patients admitted with acute dyspnea to the ED. |
| Keywords: | BNP Dyspnea Elderly Heart failure Natriuretic peptides NT-proBNP Emergency department |
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