The report from researchers at Massachusetts General Hospital (MGH) finds that measuring levels of a protein called NT-proBNP was significantly better at identifying heart failure than was standard clinical evaluation.
"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., MD, of the MGH Cardiology Division, the paper's lead author.
"Importantly, we also found that the very best results came from combining the results of this very sensitive and specific blood test with the logic and wisdom of a good emergency physician, which gave the optimal balance between biologic data and clinical judgement."
About 600 patients who came to the MGH Emergency Department with shortness of breath were enrolled in the study. In addition to standard evaluation of symptoms, a blood sample was drawn for NT-proBNP measurement. After the emergency assessment was completed, the attending physicians were asked to estimate the likelihood that the patients' symptoms were caused by heart failure, based on all available information except the NT-proBNP assay.
For patients admitted to the hospital, the entire record of their stay was included in the study data. Sixty days after the original emergency visit, the researchers followed up with each patient, contacting them personally and reviewing their records to identify any subsequent clinical events. Participation in the study in no way changed the care or treatment the patients received.
"We've shown that this test not only can confidently exclude the presence of congestive heart failure, which other studies have examined, but can confirm that diagnosis as well. NT-proBNP performed exceptionally well and confirms the value of the natriuretic peptide class of cardiac biomarkers as a whole," Januzzi says.
MEDICA.de; Source: Massachusetts General Hospital