Clinical utility of NT-pro BNP in patients with acute cardiac failure: an observational study

Abstract

Background. BNP along with its inactive N-terminal fragment, NT-pro BNP, plays a crucial role as serum biomarkers in the management of heart failure (HF). Increased levels indicate various pathophysiological processes such as cardiac structural and functional abnormalities, myocardial stretching caused by heightened filling pressure, and activation of neuro-hormones. Aim. To evaluate the clinical use of NT-Pro BNP in cases of suspected cardiac failure and its effectiveness in distinguishing between cardiac and respiratory dyspnea. Materials and methods. The research was carried out at Saveetha Medical College in Chennai, Tamil Nadu, India, as a case-control study. One hundred patients, between the ages of 40 and 70, who were suspected of having Acute cardiac failure, were recruited for the study from January 2023 to January 2024. Results. The proportion of people with cardiac dysfunction as evaluated by Echocardiography was 69% in the study population, and the mean NT pro-BNP was significantly higher among the cardiac dysfunction group as compared to the pulmonary dysfunction group. The NT PRO BNP's predictive validity was shown to be good (AUC 0.871, 95% CI 0.780 to 0.961, p-value <0.001). Conclusion. The current study has tested the sensitivity and various cut-off values of NT Pro BNP and found the cut-off level of ≥1000 may be the ideal cut-off level, as it provided a better combination of sensitivity and specificity (87% and 74.2% respectively). A lower cut-off value (500) leads to an increase in sensitivity (98.6%), at the cost of specificity (64.5%).