Point-of-care N-terminal pro-brain natriuretic peptide testing in patients with heart failure: data from the DREAM study

Abstract

Aim. To compare the blood levels of N-terminal pro-brain natriuretic peptide (NTproBNP), determined using a Russian semi-quantitative point-of-care test and quantitative laboratory tests, depending on the presence and severity of heart failure (HF) and left ventricular (LV) function.Material and methods. This Diagnosis of chRonic hEart fAilure using a NTproBNP test Multicenter study (DREAM) was conducted in 79 patients with HF and 24 healthy individuals. Blood NT-proBNP concentrations assessed using an immunochromatographic semiquantitative rapid test were compared with quantitative laboratory test results, severity of heart failure, and LV function.Results. The study showed that the NT-proBNP rapid test results were highly correlated (correlation coefficient 0,74) with the quantitative test. The NT-proBNP level assessed by the rapid test increases in patients with higher NYHA HF class and does not differ significantly from the quantitative test grades. The sensitivity, specificity, positive predictive value, and negative predictive value of the test result relative to natriuretic peptide quantification were 0,97, 0,78, 0,91, and 0,93, respectively. Sensitivity, specificity, positive and negative predictive value of the test result regarding NYHA classes II-IV were 0,95, 0,85, 0,95 and 0,85, and regarding LV ejection fraction <50% — 1,0, 0,24, 0,24, and 1,0, respectively. False-positive rate in the healthy individuals' group were low (4%).Conclusion. The results of the NT-proBNP rapid test demonstrated acceptable diagnostic accuracy compared to quantitative assessment in patients with HF of varying severity and LV ejection fraction.