Does B-Type Natriuretic Peptide Testing Affect Outcome and Management of Patients With Acute Dyspnea?
Authors: Franca Dipaola
Journal: Annals of Internal Medicine (2009)

Letters18 August 2009Does B-Type Natriuretic Peptide Testing Affect Outcome and Management of Patients With Acute Dyspnea?Franca Dipaola, MD, Francesca Perego, MD, Monica Solbiati, MD, and Giovanni Casazza, PhD, on behalf of the Gruppo di Autoformazione MetodologicaFranca Dipaola, MDFrom Universitaria Ospedale Medicina Interna, 20099 Sesto San Giovanni, Italy; Universitaria Ospedale Medicina Interna II, 20157 Milan, Italy; and Università degli Studi di Milano, 20133 Milan, Italy.Search for more papers by this author, Francesca Perego, MDFrom Universitaria Ospedale Medicina Interna, 20099 Sesto San Giovanni, Italy; Universitaria Ospedale Medicina Interna II, 20157 Milan, Italy; and Università degli Studi di Milano, 20133 Milan, Italy.Search for more papers by this author, Monica Solbiati, MDFrom Universitaria Ospedale Medicina Interna, 20099 Sesto San Giovanni, Italy; Universitaria Ospedale Medicina Interna II, 20157 Milan, Italy; and Università degli Studi di Milano, 20133 Milan, Italy.Search for more papers by this author, and Giovanni Casazza, PhDFrom Universitaria Ospedale Medicina Interna, 20099 Sesto San Giovanni, Italy; Universitaria Ospedale Medicina Interna II, 20157 Milan, Italy; and Università degli Studi di Milano, 20133 Milan, Italy.Search for more papers by this author, on behalf of the Gruppo di Autoformazione MetodologicaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-4-200908180-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the article by Schneider and colleagues (1) about the use of BNP testing in emergency department patients with dyspnea. However, we believe that several key issues need clarification.Schneider and colleagues reported no significant differences between BNP-tested and control groups in emergency department use of medications. It would be interesting to analyze how BNP-tested and non–BNP-tested groups were treated on the basis of final diagnosis to evaluate whether knowledge of BNP results (<100 or >500 ng/L, used as cutoff values for exclusion or confirmation of heart failure diagnosis, respectively [2]) influenced therapeutic approach. ...References1. Schneider HG, Lam L, Lokuge A, Krum H, Naughton MT, De Villiers Smit P, et al. B-type natriuretic peptide testing, clinical outcomes, and health services use in emergency department patients with dyspnea: a randomized trial. Ann Intern Med. 2009;150:365-71. [PMID: 19293069] LinkGoogle Scholar2. McCullough PA, Nowak RM, McCord J, Hollander JE, Herrmann HC, Steg PG, et al. B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study. Circulation. 2002;106:416-22. [PMID: 12135939] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Universitaria Ospedale Medicina Interna, 20099 Sesto San Giovanni, Italy; Universitaria Ospedale Medicina Interna II, 20157 Milan, Italy; and Università degli Studi di Milano, 20133 Milan, Italy.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoB-Type Natriuretic Peptide Testing, Clinical Outcomes, and Health Services Use in Emergency Department Patients With Dyspnea Hans-Gerhard Schneider , Louisa Lam , Amaali Lokuge , Henry Krum , Matthew T. Naughton , Pieter De Villiers Smit , Adam Bystrzycki , David Eccleston , Jacob Federman , Genevieve Flannery , and Peter Cameron Does B-Type Natriuretic Peptide Testing Affect Outcome and Management of Patients With Acute Dyspnea? Hans-Gerhard Schneider , Louisa Lam , and Peter Cameron Does B-Type Natriuretic Peptide Testing Affect Outcome and Management of Patients With Acute Dyspnea? Mihály Tapolyai Does B-Type Natriuretic Peptide Testing Affect Outcome and Management of Patients With Acute Dyspnea? Ajay Pachika , Malek Numeir , and Kiranmayi Adimoolam Metrics 18 August 2009Volume 151, Issue 4Page: 289KeywordsBrain natriuretic peptidesDecision makingDyspneaHeart failureLongitudinal studiesNatriuretic peptidesOxygenRespiratory rateStatistical distributions ePublished: 18 August 2009 Issue Published: 18 August 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...