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ntually diagnosed with heart failure and highest in those with most severe symptoms. For identifying heart failure in these emergency patients, the test alone was significantly more accurate than was the physicians' original likelihood assessment, but a combination of NT-proBNP levels and physician judgement produced the most accurate method of diagnosis.

"We also identified specific NT-proBNP levels above which the diagnosis of heart failure is clear and below which the symptoms are definitely not cardiac-related," Januzzi says. "So we've shown that this test not only can confidently exclude the presence of congestive heart failure, which other studies have examined, but can confirm that diagnosis as well. NT-proBNP performed exceptionally well and confirms the value of the natriuretic peptide class of cardiac biomarkers as a whole. We believe NT-proBNP testing should now become a routine component of evaluation for patients with shortness of breath in emergency department settings." Januzzi is an assistant professor of Medicine at Harvard Medical School.

Co-authors of the study all from the MGH are Carlos Camargo, MD, PhD; Saif Anwaruddin, MD; Aaron Baggish, MD; Annabel Chen, MD; Daniel Krauser, MD; Roderick Tung, MD; Renee Cameron, MS; Tobias Nagurney, MD; Claudia Chae, MD, MPH; Donald Lloyd-Jones, MD, ScM; David Brown, MD; Stacy Foran-Melanson, MD, PhD; Patrick Sluss, MD, PhD; Elizabeth Lee-Lewandrowski, PhD, MPH; and Kent Lewandrowski, MD. The study was supported by a grant from Roche Diagnostics, which manufacturers the NT-proBNP assay studied.

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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
11-Apr-2005

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