Is BNP useful in diagnosing heart failure in patients presenting with dyspnea?

Systematic review

Wang CS, et al. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005 Oct 19;294(15):1944-56.

Objective: Assess the usefulness of exam, including routine diagnostic studies, such as serum B-type natriuretic peptide [BNP], that differentiate heart failure from other causes of dyspnea in the emergency department.  Includes

♦Searched MEDLINE (1966-July 2005) and the reference lists from retrieved articles, previous reviews, and physical examination textbooks
♦2 authors independently abstracted data and assessed methodological quality

♦Specifically excluded studies with convenience samples including patients who obviously had the disease and studies with unvalidated reference standard in convenience samples

11 studies (N=3,302) evaluated cutoffs of serum BNP in diagnosing heart failure in the emergency department.
Table 5 shows the pooled sensitivities, specificities and likelihood ratios of various cutoffs.

***More information on diagnosing heart failure available in The Rational Clinical Examination in JAMAevidence


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Clinical Informationist at EUH Branch Library
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