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Can brain natriuretic peptide (BNP) be used as a screening tool in general practice?
Maria Schaufelberger1, Claes-Håkan Bergh, Kenneth Caidahl
1Department of Cardiology, Mölnlycke Primary Health Care and Research Centre, Mölnlycke, Sweden.
Objective:
To investigate plasma brain natriuretic peptide (p-BNP) in consecutive primary care patients for heart failure screening.
Design:
Open, descriptive.
Setting:
Three primary care clinics, university hospital.
Subjects:
291 consecutive patients, > or =40 years.
Main Outcome Measures:
p-BNP and general practitioners estimated probability of CHF.
Results:
Median p-BNP was 29 ng/L. In 42% p-BNP was >40 ng/L in the first sample. In 41 patients further investigated, median p-BNP was 98 ng/L, with a correlation between p-BNP and physicians' estimation of probability of heart failure (r=0.469, p<0.0001). New York Heart Association class was correlated to p-BNP (r=0.343, p=0.034). No correlation between ejection fraction and p-BNP was seen.
Conclusion:
P-BNP concentrations in unselected primary care patients of 40 years of age or above were elevated in a larger proportion of patients than previously reported. Owing to the low specificity, p-BNP concentration limits have to be defined before the test can be used for screening in primary care.
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