The N-terminal Pro-BNP investigation of dyspnea in the emergency department (PRIDE) study.

Published

Journal Article

The utility of aminoterminal pro-brain natriuretic peptide (NT-proBNP) testing in the emergency department to rule out acute congestive heart failure (CHF) and the optimal cutpoints for this use are not established. We conducted a prospective study of 600 patients who presented in the emergency department with dyspnea. The clinical diagnosis of acute CHF was determined by study physicians who were blinded to NT-proBNP results. The primary end point was a comparison of NT-proBNP results with the clinical assessment of the managing physician for identifying acute CHF. The median NT-proBNP level among 209 patients (35%) who had acute CHF was 4,054 versus 131 pg/ml among 390 patients (65%) who did not (p <0.001). NT-proBNP at cutpoints of >450 pg/ml for patients <50 years of age and >900 pg/ml for patients >or=50 years of age were highly sensitive and specific for the diagnosis of acute CHF (p <0.001). An NT-proBNP level <300 pg/ml was optimal for ruling out acute CHF, with a negative predictive value of 99%. Increased NT-proBNP was the strongest independent predictor of a final diagnosis of acute CHF (odds ratio 44, 95% confidence interval 21.0 to 91.0, p <0.0001). NT-proBNP testing alone was superior to clinical judgment alone for diagnosing acute CHF (p = 0.006); NT-proBNP plus clinical judgment was superior to NT-proBNP or clinical judgment alone. NT-proBNP measurement is a valuable addition to standard clinical assessment for the identification and exclusion of acute CHF in the emergency department setting.

Full Text

Duke Authors

Cited Authors

  • Januzzi, JL; Camargo, CA; Anwaruddin, S; Baggish, AL; Chen, AA; Krauser, DG; Tung, R; Cameron, R; Nagurney, JT; Chae, CU; Lloyd-Jones, DM; Brown, DF; Foran-Melanson, S; Sluss, PM; Lee-Lewandrowski, E; Lewandrowski, KB

Published Date

  • April 2005

Published In

Volume / Issue

  • 95 / 8

Start / End Page

  • 948 - 954

PubMed ID

  • 15820160

Pubmed Central ID

  • 15820160

Electronic International Standard Serial Number (EISSN)

  • 1879-1913

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/j.amjcard.2004.12.032

Language

  • eng