Tags

Type your tag names separated by a space and hit enter

Neither race nor gender influences the usefulness of amino-terminal pro-brain natriuretic peptide testing in dyspneic subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy.
J Card Fail. 2006 Aug; 12(6):452-7.JC

Abstract

BACKGROUND

Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is useful for the diagnosis and exclusion of congestive heart failure (HF). Little is known about the effect of race on NT-proBNP concentrations. Also, NT-proBNP levels may be higher in apparently well women, but the effect of gender on NT-proBNP concentrations in dyspneic patients is not known.

METHODS AND RESULTS

NT-proBNP (Elecsys proBNP, Roche, Indianapolis, IN) was measured in 599 dyspneic patients in a prospective study. Of these, 44 were African American; 295 were female. NT-proBNP levels were examined according to race and gender in patients with and without acute HF using analysis of covariance. Receiver operating characteristic (ROC) curves assessed NT-proBNP by race and gender. Cutpoints for diagnosis (450, 900, and 1800 pg/mL for ages < 50, 50 to 75, and > 75 years) and exclusion (300 pg/mL) were examined in African-American and female subjects. There was no difference in the rates of acute HF between African-American and non-African-American (30% versus 35%, P = .44) or male and female (35% versus 35%, P = .86) subjects. In subjects with HF, there was no difference in median NT-proBNP concentrations between African American and non-African American (6196 versus 3597 pg/mL, P = .37). In subjects without HF, unadjusted NT-proBNP levels were lower in African-American subjects than in non-African-American subjects (68 versus 148 pg/mL, P < .03); however, when adjusted for factors known to influence NT-proBNP concentrations (age, prior HF, creatinine clearance, atrial fibrillation, and body mass index), race no longer significantly affected NT-proBNP concentrations. There was no statistical difference in median NT-proBNP concentrations between male and female subjects with (4686 versus 3622 pg/mL, P = .53) or without HF (116 pg/mL versus 150 pg/mL, P = .62). Among African Americans, NT-proBNP had an area under the ROC for acute HF of 0.96 (P < .0001), and at optimal cutpoints, had a sensitivity of 100% and a specificity of 90%. Among females, NT-proBNP had an area under the ROC for acute HF of 0.95 (P < .0001), and had a sensitivity of 89% and a specificity of 88%; 300 pg/mL had negative predictive value of 100% in African Americans and females.

CONCLUSION

NT-proBNP is useful for the diagnosis and exclusion of acute HF in dyspneic subjects, irrespective of race or gender.

Authors+Show Affiliations

Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16911912

Citation

Krauser, Daniel G., et al. "Neither Race nor Gender Influences the Usefulness of Amino-terminal Pro-brain Natriuretic Peptide Testing in Dyspneic Subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) Substudy." Journal of Cardiac Failure, vol. 12, no. 6, 2006, pp. 452-7.
Krauser DG, Chen AA, Tung R, et al. Neither race nor gender influences the usefulness of amino-terminal pro-brain natriuretic peptide testing in dyspneic subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. J Card Fail. 2006;12(6):452-7.
Krauser, D. G., Chen, A. A., Tung, R., Anwaruddin, S., Baggish, A. L., & Januzzi, J. L. (2006). Neither race nor gender influences the usefulness of amino-terminal pro-brain natriuretic peptide testing in dyspneic subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. Journal of Cardiac Failure, 12(6), 452-7.
Krauser DG, et al. Neither Race nor Gender Influences the Usefulness of Amino-terminal Pro-brain Natriuretic Peptide Testing in Dyspneic Subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) Substudy. J Card Fail. 2006;12(6):452-7. PubMed PMID: 16911912.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neither race nor gender influences the usefulness of amino-terminal pro-brain natriuretic peptide testing in dyspneic subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. AU - Krauser,Daniel G, AU - Chen,Annabel A, AU - Tung,Roderick, AU - Anwaruddin,Saif, AU - Baggish,Aaron L, AU - Januzzi,James L,Jr PY - 2006/03/07/received PY - 2006/04/23/revised PY - 2006/04/28/accepted PY - 2006/8/17/pubmed PY - 2006/10/13/medline PY - 2006/8/17/entrez SP - 452 EP - 7 JF - Journal of cardiac failure JO - J Card Fail VL - 12 IS - 6 N2 - BACKGROUND: Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is useful for the diagnosis and exclusion of congestive heart failure (HF). Little is known about the effect of race on NT-proBNP concentrations. Also, NT-proBNP levels may be higher in apparently well women, but the effect of gender on NT-proBNP concentrations in dyspneic patients is not known. METHODS AND RESULTS: NT-proBNP (Elecsys proBNP, Roche, Indianapolis, IN) was measured in 599 dyspneic patients in a prospective study. Of these, 44 were African American; 295 were female. NT-proBNP levels were examined according to race and gender in patients with and without acute HF using analysis of covariance. Receiver operating characteristic (ROC) curves assessed NT-proBNP by race and gender. Cutpoints for diagnosis (450, 900, and 1800 pg/mL for ages < 50, 50 to 75, and > 75 years) and exclusion (300 pg/mL) were examined in African-American and female subjects. There was no difference in the rates of acute HF between African-American and non-African-American (30% versus 35%, P = .44) or male and female (35% versus 35%, P = .86) subjects. In subjects with HF, there was no difference in median NT-proBNP concentrations between African American and non-African American (6196 versus 3597 pg/mL, P = .37). In subjects without HF, unadjusted NT-proBNP levels were lower in African-American subjects than in non-African-American subjects (68 versus 148 pg/mL, P < .03); however, when adjusted for factors known to influence NT-proBNP concentrations (age, prior HF, creatinine clearance, atrial fibrillation, and body mass index), race no longer significantly affected NT-proBNP concentrations. There was no statistical difference in median NT-proBNP concentrations between male and female subjects with (4686 versus 3622 pg/mL, P = .53) or without HF (116 pg/mL versus 150 pg/mL, P = .62). Among African Americans, NT-proBNP had an area under the ROC for acute HF of 0.96 (P < .0001), and at optimal cutpoints, had a sensitivity of 100% and a specificity of 90%. Among females, NT-proBNP had an area under the ROC for acute HF of 0.95 (P < .0001), and had a sensitivity of 89% and a specificity of 88%; 300 pg/mL had negative predictive value of 100% in African Americans and females. CONCLUSION: NT-proBNP is useful for the diagnosis and exclusion of acute HF in dyspneic subjects, irrespective of race or gender. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/16911912/Neither_race_nor_gender_influences_the_usefulness_of_amino_terminal_pro_brain_natriuretic_peptide_testing_in_dyspneic_subjects:_a_ProBNP_Investigation_of_Dyspnea_in_the_Emergency_Department__PRIDE__substudy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(06)00225-9 DB - PRIME DP - Unbound Medicine ER -