XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
  Hypertension
  CAD
  Myocardial Infarction
  CHF
  Clinical Trials
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
 Pathology
 Endocrinology
 Immunology
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
Search

Last Updated: Aug 19th, 2006 - 22:18:38

CHF Channel
subscribe to CHF newsletter

Latest Research : Cardiology : CHF

   DISCUSS   |   EMAIL   |   PRINT
NT-proBNP test results comparable to those of BNP blood test in patients with kidney disease
Dec 15, 2005, 16:28, Reviewed by: Dr. Sanjukta Acharya

"It is well understood that kidney disease reduces the usefulness of testing for both NT-proBNP and a related biomarker called BNP, and the conventional understanding was that NT-proBNP was the more affected of the two. However, while kidney disease did lead to higher values of NT-proBNP in our study, what really matters is clinical performance; and at optimal cut-points, no matter how hard we looked, we found the relationship between chronic kidney disease and the diagnostic accuracy of NT-proBNP was no different than that of BNP. Our findings thus directly contradict observations based on smaller, less characterized patient populations."

 
A large-scale analysis has shown that a blood test previously found useful in diagnosing or ruling out heart failure in emergency room patients remains effective in patients with chronic kidney disease. The study also demonstrates that the test for a marker called NT-proBNP can identify patients at a higher risk for death, independent of kidney dysfunction. The report from investigators at the Massachusetts General Hospital (MGH) will appear in the January 3, 2006 Journal of the American College of Cardiology and is receiving early online release.

"It is well understood that kidney disease reduces the usefulness of testing for both NT-proBNP and a related biomarker called BNP, and the conventional understanding was that NT-proBNP was the more affected of the two," says James Januzzi Jr., MD, of the MGH Cardiology Division, the paper's senior author. "However, while kidney disease did lead to higher values of NT-proBNP in our study, what really matters is clinical performance; and at optimal cut-points, no matter how hard we looked, we found the relationship between chronic kidney disease and the diagnostic accuracy of NT-proBNP was no different than that of BNP. Our findings thus directly contradict observations based on smaller, less characterized patient populations."

Congestive heart failure, which occurs when an impaired heart muscle cannot pump blood efficiently, is a growing health problem and major cause of cardiac death. The diagnosis of heart failure may be challenging because its symptoms can overlap those of other conditions. Missing a heart failure diagnosis can put patients at high risk of serious problems, including death, but overdiagnosis may lead patients to receive unnecessary treatment.

Published earlier this year, the PRIDE study showed NT-proBNP to be highly sensitive and specific for the diagnosis of acute heart failure in patients with shortness of breath and to strongly predict patient deaths. A major concern about the widespread use of the marker had been previous assertions that kidney disease very common in patients with heart failure might confound the results of NT-proBNP testing, since levels of the marker were higher among those with reduced renal function.

Some researchers in the field argued that BNP was less affected by chronic kidney disease than was NT-proBNP. "We found no difference in our results when you examine them side-by-side with those for BNP," says Januzzi. "When you consider the data in totality, there just does not seem to be much difference between these two markers with respect to their diagnostic usefulness in patients with kidney disease. While kidney disease modestly reduces the diagnostic accuracy of both markers, when used in the appropriate manner, both tests appear to return identical information."

Besides the diagnostic value of NT-proBNP, the analysis evaluated the prospective value of NT-proBNP testing for predicting death within 60 days. "In fact, NT-proBNP measurement was an even stronger predictor of death in breathless patients with significant renal insufficiency, emphasizing the fact that the marker is likely detecting a true signal of cardiac disease in these patients," said Januzzi, an assistant professor of Medicine at Harvard Medical School. "This is a big step forward in the understanding of the optimal application of NT-proBNP measurement, as it removes one of the biggest obstacles that remained for the marker."
 

- January 3, 2006 Journal of the American College of Cardiology
 

www.mgh.harvard.edu

 
Subscribe to CHF Newsletter
E-mail Address:

 

Co-authors of the study include first author Saif Anwaruddin, MD, now a fellow in cardiology at the Cleveland Clinic Foundation; Aaron Baggish, MD, Annabel Chen, MD, and Claudia Chae, MD, MPH, of MGH Cardiology; Donald M. Lloyd-Jones, MD, MsC, Northwestern University; Daniel Krauser, MD, New York Hospital; and Roderick Tung, MD, Cedars-Sinai Hospital, Los Angeles. The study was supported by a grant from Roche Diagnostics, which manufactures the NT-proBNP assay studied.

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of nearly $500 million and major research centers in AIDS, cardiovascular research, cancer, cutaneous biology, medical imaging, neurodegenerative disorders, transplantation biology and photomedicine. In 1994, MGH and Brigham and Women's Hospital joined to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups, and nonacute and home health services.


Related CHF News

Seven-point system gauges seriousness of heart failure in elderly
Famotidine may help to slow progression of chronic heart failure
Ilk gene underlies heart failure
Nocturnal Hypertension Increase Congestive Heart Failure Risk
Gender-based differences seen in predictive value of exercise test results of heart failure patients
Training program may reverse underlying abnormalities in heart failure more effectively than drug treatment
Acetazolamide improves sleep apnea associated with heart failure
NT-proBNP test results comparable to those of BNP blood test in patients with kidney disease
Moderate exercise may delay congestive heart failure
Pulmonary artery catheter in critically ill has neutral effect


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us