Importance of B-Type Natriuretic Peptide in the Detection of Patients With Structural Heart Disease in a Primary Care Setting

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  • Fujimoto Wataru
    Division of Cardiovascular Medicine, Hyogo Prefectural Awaji Medical Center Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
  • Odajima Susumu
    Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
  • Okamoto Hiroshi
    Okamoto Cardiovascular Clinic
  • Iwasaki Masamichi
    Division of Cardiovascular Medicine, Hyogo Prefectural Awaji Medical Center
  • Nagao Manabu
    Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine
  • Konishi Akihide
    Clinical and Translational Research Center, Kobe University Hospital
  • Shinohara Masakazu
    Division of Molecular Epidemiology, Kobe University Graduate School of Medicine
  • Toh Ryuji
    Division of Evidence-based Laboratory Medicine, Kobe University Graduate School of Medicine
  • Okuda Masanori
    Division of Cardiovascular Medicine, Hyogo Prefectural Awaji Medical Center
  • Hirata Ken-ichi
    Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
  • Tanaka Hidekazu
    Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine

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<p>Background: Early detection and intervention for preclinical heart failure (HF) are crucial for restraining the potential increase in patients with HF. Thus, we designed and conducted a single-center retrospective cohort study to confirm the efficacy of B-type natriuretic peptide (BNP) for the early detection of preclinical HF in a primary care setting.</p><p>Methods and Results: We investigated 477 patients with no prior diagnosis of HF who were under the care of general practitioners. These patients were categorized into 4 groups based on BNP concentrations: Category 1, 0 pg/mL≤BNP≤35 pg/mL; Category 2, 35 pg/mL<BNP≤100 pg/mL; Category 3, 100 pg/mL<BNP≤200 pg/mL; and Category 4, BNP >200 pg/mL. There was a marked and statistically significant increase in the prevalence of preclinical HF with increasing BNP categories: 19.9%, 57.9%, 87.5%, and 96.0% in Categories 1, 2, 3, and 4, respectively. Compared with Category 1, the odds ratio of preclinical HF in Categories 2, 3, and 4 was determined to be 5.56 (95% confidence interval [CI] 3.57–8.67), 23.70 (95% CI 8.91–63.11), and 171.77 (95% CI 10.31–2,861.93), respectively.</p><p>Conclusions: Measuring BNP is a valuable tool for the early detection of preclinical HF in primary care settings. Proactive testing in patients at high risk of HF could play a crucial role in addressing the impending HF pandemic.</p>

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  • Circulation Journal

    Circulation Journal 88 (5), 732-739, 2024-04-25

    一般社団法人 日本循環器学会

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