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Routine use of natriuretic peptides: Lessons from a big data analysis
F X Goudot1, S Msadek1, T Boukertouta1
1Cardiology Department, Avicenne University Hospital, APHP, Université Sorbonne Paris Nord, Bobigny, France.
Annals of Clinical Biochemistry
|May 19, 2021
Summary
Natriuretic peptides like NT-proBNP are underused in routine practice, especially in younger patients. Interpretation of NT-proBNP results may be unreliable in nearly 16% of cases due to missing creatinine measurements.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Practice
Background:
- Natriuretic peptides are vital for diagnosing heart failure and left ventricular dysfunction.
- Their application extends to other cardiac conditions, but routine practice use is under-researched.
Purpose of the Study:
- To investigate the real-world utilization patterns of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in routine clinical practice.
- To identify factors influencing NT-proBNP testing and potential limitations in its interpretation.
Main Methods:
- Analysis of biological tests from February 2010 to August 2015 in two French districts.
- Inclusion of data from 22,265 physicians and over 3.6 million tests from adult patients.
- Focus on NT-proBNP measurements, their ordering physicians, and laboratory settings.
Main Results:
- Only 1.6% of adult patients had NT-proBNP measured, with usage increasing over time.
- Tests were predominantly ordered by general practitioners in urban, private laboratories, and primarily for patients aged 75+.
- Creatinine and electrolyte measurements were missing in 15.8% and 19.7% of NT-proBNP tests, respectively.
Conclusions:
- Natriuretic peptide (NT-proBNP) testing remains significantly underutilized in routine care.
- Testing is concentrated in elderly populations, potentially limiting broader diagnostic utility.
- Incomplete associated tests (e.g., creatinine) pose a risk for inaccurate NT-proBNP interpretation.
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