“We found that testing with the NT-proBNP assay was an extremely accurate way to identify or exclude heart failure in patients with shortness of breath,” says James Januzzi Jr., M.D., of the MGH Cardiology Division and the paper’s lead author.
Since current standards of treatment are inconsistent, Januzzi says, this new test could prove a major development.
The role of testing for natriuretic peptides in cardiovascular disease has been widely studied recently. In 2002, the newest generation of natriuretic peptide assays became available, and soon thereafter the PRIDE study was launched to determine the usefulness of a test for NT-proBNP in evaluating emergency patients.
The study was composed of patients who came to the MGH Emergency Department with shortness of breath and who received emergency assessment. The attending physicians then estimated the likelihood that the patients’ symptoms were caused by heart failure, based on all available information except the NT-proBNP assay. Sixty days after the original emergency visit, the researchers reviewed each patient’s records for subsequent clinical events.
To make diagnoses for this study, cardiologists not involved in the patients’ care reviewed all the participants’ relevant hospital records, without the NT-proBNP results.
The researchers found that NT-proBNP concentrations were significantly higher in patients eventually diagnosed with heart failure and highest in those with most severe symptoms. Although the test alone is more useful than only a physician’s assessment, a combination of test and assessment is optimal.