NT-proBNP and D-Dimer in acute decompensated heart failure: assessment of diagnostic accuracy and correlation with
Nandini Nair1, Shengping Yang1, Caroline Marzbani1
1Division of Cardiology, Department of Medicine, TTUHSC, Lubbock, TX, USA.
Insights
In acute decompensated heart failure, NT-proBNP and D-Dimer show comparable diagnostic accuracy. D-Dimer levels correlate with NT-proBNP but not echocardiographic findings, suggesting unique mechanisms.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Pathophysiology
Background:
- Coagulation and inflammation are altered in heart failure.
- Biomarkers like NT-proBNP and D-Dimer are crucial for diagnosis and prognosis.
- Understanding their roles in acute decompensated heart failure (ADHF) is essential.
Purpose of the Study:
- To compare the diagnostic accuracy of NT-proBNP and D-Dimer in ADHF.
- To assess the correlation between these biomarkers and echocardiographic parameters.
- To elucidate the pathophysiological significance of D-Dimer in ADHF.
Main Methods:
- Retrospective cross-sectional study of 162 ADHF patients and 253 controls.
- Exclusion of pulmonary embolism using CT or VQ scans.
- Correlation analysis of NT-proBNP and D-Dimer with echocardiographic data.
Main Results:
- NT-proBNP and D-Dimer demonstrated high diagnostic accuracy (AUCs 0.963 and 0.928).
- A combination of both biomarkers showed a slightly higher AUC (0.982) but not statistically significant compared to D-Dimer alone.
- NT-proBNP correlated significantly with echocardiographic parameters, while D-Dimer did not.
Conclusions:
- NT-proBNP and D-Dimer exhibit comparable diagnostic utility in ADHF.
- D-Dimer's lack of correlation with echocardiographic findings suggests independent mechanisms in ADHF.
- Further research is needed to clarify the role of D-Dimer in heart failure pathophysiology.
Purpose:
Abnormalities in coagulation and inflammation exist in heart failure. This study compares the diagnostic accuracy of NT-proBNP and D-Dimer and the correlation of these biomarkers with echocardiographic parameters in acute decompensated heart failure.
Methods:
A retrospective cross-sectional/observational study was performed using 162 patients with acute decompensated heart failure and 253 age-matched controls. Patients were ruled out for a pulmonary embolus by CT or VQ scans. The study protocol was approved by Institutional Review Board, Lubbock, TX. Correlation of NT-proBNP and D-Dimer values was done with echocardiographic parameters. Statistical significance was assumed at p < 0.05.
Results:
D-Dimer showed a positive correlation with NT-proBNP (r = 0.665, p = 001). The AUC for NT-proBNP, D-Dimer and a combination of D-Dimer plus NT-proBNP were 0.963, 0.928 and 0.982 respectively. The AUC value for D-Dimer versus the combination of D-Dimer and NT-roBNP was not significant (p = 0.21). Correlation of NT-proBNP was significant with the echocardiographic parameters but D-Dimer did not significantly correlate with any of the echocardiographic parameters studied.
Conclusions:
Comparison of the AUC values for D-Dimer versus the combination of D-Dimer and NT-proBNP showed no significance suggestive of comparable diagnostic accuracy in the study population. The lack of correlation between D-Dimer and echocardiographic parameters suggests an independent pathophysiological mechanism underlying upregulation of D-Dimer in acute decompensated heart failure. Further systematic studies are needed to define mechanism of D-Dimer increase in heart failure.
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