Bottom line: BMI is associated with lower BNP measures in patients with BMI ≥ 35 and in diagnosing acute HF a lower cut-point (BNP > or = 54 pg/mL) should
Details: Am Heart J. 2006 May;151(5):999-1005. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Daniels LB, et al.
In the Breathing Not Properly Multinational Study–prospective study, n=1586 patients who presented to the Emergency Department with acute dyspnea. BNP was measured on arrival. Height and weight data recorded for 1368 patients. The reference standard diagnosis of heart failure was by 2 independent cardiologists blinded to BNP results. Patients analyzed in three groups–BMI<25, 25 ≤ BMI < 35 and BMI ≥ 35. RESULTS: Cut-points for achieving 90% sensitivity in each group were calculated:
BMI<25 – cut-point of 170
25 ≤ BMI < 35 – cut-point of 110
BMI ≥ 35 – cut-point of 54