Featured Research

from universities, journals, and other organizations

Blood Test Can Accurately Diagnose Heart Failure In Patients With Kidney Dysfunction

Date:
December 19, 2005
Source:
Massachusetts General Hospital
Summary:
A large-scale analysis has shown that a blood test previously found useful in diagnosing or ruling out heart failure in emergency room patients remains effective in patients with chronic kidney disease. The study also demonstrates that the test for a marker called NT-proBNP can identify patients at a higher risk for death, independent of kidney dysfunction.

A large-scale analysis has shown that a blood test previously found useful in diagnosing or ruling out heart failure in emergency room patients remains effective in patients with chronic kidney disease. The study also demonstrates that the test for a marker called NT-proBNP can identify patients at a higher risk for death, independent of kidney dysfunction. The report from investigators at the Massachusetts General Hospital (MGH) will appear in the January 3, 2006 Journal of the American College of Cardiology and is receiving early online release.

"It is well understood that kidney disease reduces the usefulness of testing for both NT-proBNP and a related biomarker called BNP, and the conventional understanding was that NT-proBNP was the more affected of the two," says James Januzzi Jr., MD, of the MGH Cardiology Division, the paper's senior author. "However, while kidney disease did lead to higher values of NT-proBNP in our study, what really matters is clinical performance; and at optimal cut-points, no matter how hard we looked, we found the relationship between chronic kidney disease and the diagnostic accuracy of NT-proBNP was no different than that of BNP. Our findings thus directly contradict observations based on smaller, less characterized patient populations."

Congestive heart failure, which occurs when an impaired heart muscle cannot pump blood efficiently, is a growing health problem and major cause of cardiac death. The diagnosis of heart failure may be challenging because its symptoms can overlap those of other conditions. Missing a heart failure diagnosis can put patients at high risk of serious problems, including death, but overdiagnosis may lead patients to receive unnecessary treatment.

Published earlier this year, the PRIDE study showed NT-proBNP to be highly sensitive and specific for the diagnosis of acute heart failure in patients with shortness of breath and to strongly predict patient deaths. A major concern about the widespread use of the marker had been previous assertions that kidney disease -- very common in patients with heart failure -- might confound the results of NT-proBNP testing, since levels of the marker were higher among those with reduced renal function.

Some researchers in the field argued that BNP was less affected by chronic kidney disease than was NT-proBNP. "We found no difference in our results when you examine them side-by-side with those for BNP," says Januzzi. "When you consider the data in totality, there just does not seem to be much difference between these two markers with respect to their diagnostic usefulness in patients with kidney disease. While kidney disease modestly reduces the diagnostic accuracy of both markers, when used in the appropriate manner, both tests appear to return identical information."

Besides the diagnostic value of NT-proBNP, the analysis evaluated the prospective value of NT-proBNP testing for predicting death within 60 days. "In fact, NT-proBNP measurement was an even stronger predictor of death in breathless patients with significant renal insufficiency, emphasizing the fact that the marker is likely detecting a true signal of cardiac disease in these patients," said Januzzi, an assistant professor of Medicine at Harvard Medical School. "This is a big step forward in the understanding of the optimal application of NT-proBNP measurement, as it removes one of the biggest obstacles that remained for the marker."

###

Co-authors of the study include first author Saif Anwaruddin, MD, now a fellow in cardiology at the Cleveland Clinic Foundation; Aaron Baggish, MD, Annabel Chen, MD, and Claudia Chae, MD, MPH, of MGH Cardiology; Donald M. Lloyd-Jones, MD, MsC, Northwestern University; Daniel Krauser, MD, New York Hospital; and Roderick Tung, MD, Cedars-Sinai Hospital, Los Angeles. The study was supported by a grant from Roche Diagnostics, which manufactures the NT-proBNP assay studied.

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of nearly $500 million and major research centers in AIDS, cardiovascular research, cancer, cutaneous biology, medical imaging, neurodegenerative disorders, transplantation biology and photomedicine. In 1994, MGH and Brigham and Women's Hospital joined to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups, and nonacute and home health services.


Story Source:

The above story is based on materials provided by Massachusetts General Hospital. Note: Materials may be edited for content and length.


Cite This Page:

Massachusetts General Hospital. "Blood Test Can Accurately Diagnose Heart Failure In Patients With Kidney Dysfunction." ScienceDaily. ScienceDaily, 19 December 2005. <www.sciencedaily.com/releases/2005/12/051219235310.htm>.
Massachusetts General Hospital. (2005, December 19). Blood Test Can Accurately Diagnose Heart Failure In Patients With Kidney Dysfunction. ScienceDaily. Retrieved August 22, 2014 from www.sciencedaily.com/releases/2005/12/051219235310.htm
Massachusetts General Hospital. "Blood Test Can Accurately Diagnose Heart Failure In Patients With Kidney Dysfunction." ScienceDaily. www.sciencedaily.com/releases/2005/12/051219235310.htm (accessed August 22, 2014).

Share This




More Health & Medicine News

Friday, August 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Two US Ebola Patients Leave Hospital Free of the Disease

Two US Ebola Patients Leave Hospital Free of the Disease

AFP (Aug. 21, 2014) Two American missionaries who were sickened with Ebola while working in Liberia and were treated with an experimental drug are doing better and have left the hospital, doctors say on August 21, 2014. Duration: 01:05 Video provided by AFP
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins