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A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study

Van Cheng, BS^*, Radmila Kazanagra, MD^*, Alex Garcia, LVN^*, Leslie Lenert, MD^* , Padma Krishnaswamy, MD^*, Nancy Gardetto, NP^*, Paul Clopton, BS^* and Alan Maisel, MD, FACC^*

^* Division of Cardiology, Veteran’s Affairs Medical Center, San Diego, California, USA
Department of Medicine, University of California, San Diego, California, USA

View larger version (26K): [in a new window]   Figure 1 B-type natriuretic peptide levels and NYHA classification before and after treatment in relation to end points or no end points (successful treatment). Each value represents mean ± SEM and is analyzed by analysis of variance. BNP = B-type natriuretic peptide; NYHA = New York Heart Association.

View larger version (17K): [in a new window]   Figure 2 The relation between end points and rising versus falling BNP levels during treatment. Values are given as percentages and analyzed by chi-square analysis. BNP = B-type natriuretic peptide (p < 0.001).

View larger version (30K): [in a new window]   Figure 3 Receiver operating characteristic curves for patients with decompensated congestive heart failure compares the sensitivity and specificity of BNP measurements to 30-day readmission rates. Discrete cut-points are labeled. The AUC (C-statistic) was 0.72 for readmission. Sensitivity, specificity, positive and negative predictive values and accuracy are recorded for each cut-point of the receiver operating characteristic curve. AUC = area under the curve; BNP = B-type natriuretic peptide.