Can brain natriuretic peptide (BNP) be used as a screening tool in general practice?

Abstract

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, ≥40 years.

Main outcome measures – p-BNP and general practitioners estimated probability of chronic heart failure (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.

• BNP
• brain natriuretic peptide
• ejection fraction
• primary care

Scand J Prim Health Care 2004;22:187–190. ISSN 0281-3432

Scand J Prim Health Care 2004;22:187–190. ISSN 0281-3432