Please use this identifier to cite or link to this item: https://doi.org/10.1002/ejhf.612
Title: Superior performance of N-terminal pro brain natriuretic peptide for diagnosis of acute decompensated heart failure in an Asian compared with a Western setting
Authors: Ibrahim, Irwani 
Sen Kuan, Win 
Frampton, Chris
Troughton, Richard
Liew, Oi Wah 
Chong, Jenny Pek Ching 
Chan, Siew Pang 
Tan, Li Ling 
Lin, Wei Qin 
Pemberton, Chris J
Ooi, Shirley Beng Suat 
Richards, A Mark 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
NT-proBNP
Acute heart failure
Asia
Western
Biomarkers
TASK-FORCE
ASSOCIATION
GUIDELINES
PROGNOSIS
DYSPNEA
TRIAL
Issue Date: 1-Feb-2017
Publisher: WILEY
Citation: Ibrahim, Irwani, Sen Kuan, Win, Frampton, Chris, Troughton, Richard, Liew, Oi Wah, Chong, Jenny Pek Ching, Chan, Siew Pang, Tan, Li Ling, Lin, Wei Qin, Pemberton, Chris J, Ooi, Shirley Beng Suat, Richards, A Mark (2017-02-01). Superior performance of N-terminal pro brain natriuretic peptide for diagnosis of acute decompensated heart failure in an Asian compared with a Western setting. EUROPEAN JOURNAL OF HEART FAILURE 19 (2) : 209-217. ScholarBank@NUS Repository. https://doi.org/10.1002/ejhf.612
Abstract: © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology Aims: This study was conducted to test the diagnostic performance of NT-proBNP for discrimination of acute decompensated heart failure (ADHF) among breathless patients presenting in an Asian compared with a Western centre. Methods and results: Patients with breathlessness were prospectively and contemporaneously recruited in Emergency Departments in Singapore and New Zealand (NZ). The diagnosis of ADHF was adjudicated by two clinician specialists. A total of 606 patients were recruited in Singapore and 500 in NZ. The discriminative power of NT-proBNP for ADHF was superior in Singapore compared with NZ [area under the curve (AUC) 0.926 vs. 0.866; P = 0.012] both overall and among selected subgroups stratified according to age, renal function, body mass index, and presence or absence of AF or diabetes. Previously established cut-off point values of plasma NT-proBNP yielded comparable sensitivity and negative predictive values, but superior specificity and accuracy in Singapore compared with NZ. The difference in test performance was driven by the younger age (median age 56 years vs. 73 years; P < 0.001), associated with better renal function (estimated glomerular filtration rate 89 vs. 62 mL/min/1.73 m2; P < 0.001), and lower prevalence of AF (9.7% vs. 25.7%; P < 0.001) in acutely breathless patients in Singapore. Conclusion: Considering emerging evidence of a lower average age of presentation with ADHF over most of Asia compared with Western countries, NT-proBNP is likely to be more accurate when applied in Asian centres than in the West.
Source Title: EUROPEAN JOURNAL OF HEART FAILURE
URI: https://scholarbank.nus.edu.sg/handle/10635/155030
ISSN: 1388-9842
1879-0844
DOI: 10.1002/ejhf.612
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