Heart failureThe N-terminal Pro-BNP Investigation of Dyspnea in the Emergency department (PRIDE) study
Section snippets
Study population
The institutional review board approved all procedures involved in the PRIDE study. The PRIDE study is similar in design to the Breathing Not Properly Multinational study,3, 6 which assessed the use of BNP for patients who presented with dyspnea in the emergency department. The PRIDE study population was drawn from consenting patients ≥21 years of age who presented to the emergency department of the Massachusetts General Hospital (Boston, Massachusetts) with a complaint of dyspnea. Exclusion
Patients
Six hundred eligible patients were enrolled over 4 months. One patient withdrew consent at 60-day follow-up, leaving a final cohort of 599 patients. Of the 599 patients in the study, 209 (35%) had a final diagnosis of acute CHF, 35 (6%) had noncardiac dyspnea with a history of CHF, and the remaining 355 (59%) did not have CHF previously or the time of presentation.
Clinical characteristics
Comparisons of clinical characteristics at presentation between those patients who had acute CHF (n = 209) and those who did not (n
Discussion
Despite worldwide use of NT-proBNP testing, prospective data that examine its role in diagnosis of acute CHF in the emergency department has been limited to 2 reports with a relatively small number of patients.4, 5 In addition, although NT-proBNP is approved for ruling out CHF in the outpatient setting, the utility of the assay in the emergency department setting (for diagnosis and exclusion of acute CHF) remained unclear. Thus, the PRIDE study was prospectively performed to definitively
Acknowledgment
The investigators express their gratitude to John B. Newell, AB, for statistical analyses, the Massachusetts General Hospital Clinical Research Program for assistance in trial execution, and especially to the Massachusetts General Hospital emergency room for exceptional support and enthusiasm.
References (24)
- et al.
Plasma brain natriuretic peptide in assessment of acute dyspnoea
Lancet
(1994) - et al.
Utility of B-type natriuretic peptide in the diagnosis of congestive heart failure in an urgent-care setting
J Am Coll Cardiol
(2001) - et al.
Brain natriuretic peptide and N-terminal brain natriuretic peptide in the diagnosis of heart failure in patients with acute shortness of breath
J Am Coll Cardiol
(2003) - et al.
Detection of left ventricular enlargement and impaired systolic function with plasma N-terminal pro brain natriuretic peptide concentrations
Am Heart J
(2002) - et al.
N-terminal pro brain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation
J Am Coll Cardiol
(2002) - et al.
N-terminal pro-brain natriuretic peptide in relation to inflammation, myocardial necrosis, and the effect of an invasive strategy in unstable coronary artery disease
J Am Coll Cardiol
(2003) - et al.
B-type natriuretic peptide and renal function in the diagnosis of heart failure: an analysis from the Breathing Not Properly Multinational Study
Am J Kidney Dis
(2003) - et al.
Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea
J Am Coll Cardiol
(2002) - et al.
Multicenter evaluation of the Roche NT-proBNP assay and comparison to the Biosite Triage BNP assay
Clin Chim Acta
(2003) - et al.
Head-to-head comparison of the diagnostic utility of BNP and NT-proBNP in symptomatic and asymptomatic structural heart disease
Clin Chim Acta
(2004)
Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure
N Engl J Med
N-terminal probrain natriuretic peptide (NT-proBNP) in the emergency diagnosis and in-hospital monitoring of patients with dyspnoea and ventricular dysfunction
Eur J Heart Fail
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This study was supported by a grant from Roche Diagnostics, Indianapolis, Indiana.