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B type natriuretic peptide levels had high sensitivity but moderate specificity for detecting CHF in the emergency department

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 QUESTION: In emergency department (ED) patients with dyspnea, what are the diagnostic properties of B type natriuretic peptide (BNP) levels for detecting congestive heart failure (CHF)?


Blinded comparison of BNP levels with a confirmatory diagnosis of CHF made by 2 cardiologists who reviewed patient medical records.


5 sites in the US and 1 each in France and Norway.


1586 ED patients (mean age 64 y, 56% men) who had shortness of breath as the most prominent symptom. Exclusion criteria included age <18 years, dyspnea clearly not secondary to CHF (eg, trauma or cardiac tamponade), acute myocardial infarction, renal failure, and unstable angina without dyspnea as the primary symptom.

Description of test and diagnostic standard

The BNP level in blood or plasma samples from all patients was measured using the bedside Triage B type natriuretic fluorescence immunoassay …

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  • Source of funding: Biosite.

  • For correspondence: Dr A S Maisel, Veterans Affairs Medical Center, San Diego, California, USA. amaisel{at}

  • Abstract and commentary also published in ACP Journal Club