Comparison of the Diagnostic Characteristics of Two B-Type Natriuretic Peptide Point-of-Care Devices

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• 作者：Richard Ro ; BS ; Henry C. Thode Jr. ; PhD ; Maria Taylor ; RN ; Janet Gulla ; RN ; Ellen Tetrault ; RN ; Adam J. Singer ; MD
• 关键词：heart failure ; BNP ; diagnostic test characteristics ; point-of-care testing
• 刊名：Journal of Emergency Medicine
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：41
• 期：6
• 页码：661-667
• 全文大小：521 K

文摘

Background

B-type natriuretic peptide (BNP) is used to diagnose heart failure (HF).

Objective

To compare the accuracy of two commercially available point-of-care (POC) devices for measuring B-type natriuretic peptide (BNP) in emergency department (ED) patients with suspected heart failure using the central laboratory testing results as the criterion standard.

Methods

Venous blood samples were collected from adults with suspected heart failure and split into three samples for BNP analysis: central laboratory (Siemens ADIVA Centaur; Siemens, Deerfield, IL), Triage BNP POC device (Biosite, San Diego, CA), and i-STAT BNP POC device (Abbott, East Windsor, NJ). The criterion standard for BNP levels was the central laboratory.

Results

Two hundred fifty patients were enrolled. Mean (SD) age was 70.7 (13.8) years; 200 (80 % ) were over age 55 years; 146 (58.4 % ) were male. A final hospital discharge diagnosis of heart failure was made in 108 (42 % ) patients. The i-STAT system yielded a result within a median of 9?min (interquartile range [IQR] 9-10 min). The Triage device yielded a result within a median of 19 min (IQR 15-22 min); p < 0.001. The device failure rate for the central laboratory (8 failures, 3.2 % ) was significantly higher than that of the i-STAT device (1 failure, 0.4 % , p = 0.04), but not statistically different than the Triage device (3 failures, 1.2 % ). Neither the?Triage nor the i-STAT were statistically different than the central laboratory result in terms of sensitivity; the i-STAT was less specific than the Triage result (p = 0.003). The area under the curve for the Triage device was 0.95 (95 % confidence interval [CI] 0.91-0.98), whereas the area under the curve for the i-STAT device was 0.98 (95 % CI 0.96-0.99; p < 0.01).

Conclusions

Both POC devices tested were accurate and rarely failed; however, the i-STAT was faster with single use.