Influence of diabetes on natriuretic peptide thresholds in screening for Stage B heart failure

Chris Watson, Stephanie James, Eoin O'Connell, Joe Gallagher, James O'Reilly, Elaine Tallon, John Baugh, Jean O'Connell, Donal O'Shea, Mark Ledwidge, Ken McDonald

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Abstract

CONTEXT: Natriuretic peptide (NP) has been shown to be an effective screening tool to identify patients with Stage B heart failure and to have clinical value in preventing heart failure progression. The impact of associated metabolic confounders on the screening utility of NP needs clarification.

OBJECTIVE: To assess the impact of diabetes mellitus (DM) on NP screening for asymptomatic Stage B heart failure.

MATERIALS AND METHODS: The study population consisted of 1368 asymptomatic patients with cardiovascular risk factors recruited from general practice as part of the STOP-HF trial. B-type NP (BNP) was quantified at point-of-care.

RESULTS: BNP was found to be as accurate for detecting Stage B heart failure in DM patients compared to non-DM patients (AUC 0.75 [0.71,0.78] and 0.77 [0.72,0.82], respectively). However, different BNP thresholds are required to achieve the same level of diagnostic sensitivity in DM compared with non-DM patients. To achieve 80% sensitivity a difference of 5-ng/L lower is required for patients with DM.

CONCLUSION: Although a significantly different BNP threshold is detected for patients with DM, the BNP concentration difference is small and unlikely to warrant a clinically different diagnostic threshold.

Original languageEnglish
Number of pages6
JournalBiomarkers
Early online date06 Apr 2016
DOIs
Publication statusEarly online date - 06 Apr 2016

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    Watson, C., James, S., O'Connell, E., Gallagher, J., O'Reilly, J., Tallon, E., Baugh, J., O'Connell, J., O'Shea, D., Ledwidge, M., & McDonald, K. (2016). Influence of diabetes on natriuretic peptide thresholds in screening for Stage B heart failure. Biomarkers. https://doi.org/10.3109/1354750X.2016.1160427