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The relationship between BNP and risk assessment in cardiac rehabilitation

The relationship between BNP and risk assessment in cardiac rehabilitation
The relationship between BNP and risk assessment in cardiac rehabilitation
Risk stratification is important in the assessment of cardiac patients enrolled in physical training programmes but is often based on inadequate information. Measuring blood B-type natriuretic peptide (BNP) level, a marker of left ventricular dysfunction, might improve risk assessment. In an observational study blood BNP levels were measured in 100 consecutive patients joining a cardiac rehabilitation programme following acute myocardial infarction. The results were compared with the clinical risk assessment – high, moderate or low. There was a significant correlation between risk category (high, moderate or low) and BNP level (r=0.41, p=0.001). A BNP level of 100 pg/L or more gave a sensitivity of 89% (95% confidence interval [CI] 0.69, 0.97) and a specificity of 61% (95% CI 0.57, 0.63) for predicting high-risk patients with a positive predictive value of 33% (95% CI 0.26, 0.36) and a negative predictive value of 96% (95% CI 0.89, 0.99). A BNP level of less than 100 pg/ml gave a sensitivity of 78% (95% CI 0.55, 0.91) and a specificity of 54% (95% CI 0.43, 0.64) for predicting low-risk patients with a positive predictive value of 27% (95% CI 0.17, 0.40) and a negative predictive value of 92% (95% CI 0.80, 0.97). In conclusion, BNP levels provide information that may improve the accuracy of risk assessment of cardiac rehabilitation patients particularly when other information is limited.
0969-6113
161-165
Bethell, Hugh J.N.
49a08115-b164-4ec9-b48c-b424e94cc765
Glover, Jason D.
290a0fc0-301c-4cf9-983e-3dcfc37387c3
Evans, Julia A.
682337ec-6cbe-4467-a986-1f9dc9dece13
Turner, Sally C.
7766b219-39e1-4504-8635-df0462904734
Mehta, Raj L.
00c133aa-709b-4483-b2ee-50b835a1b8a4
Mullee, Mark A.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Bethell, Hugh J.N.
49a08115-b164-4ec9-b48c-b424e94cc765
Glover, Jason D.
290a0fc0-301c-4cf9-983e-3dcfc37387c3
Evans, Julia A.
682337ec-6cbe-4467-a986-1f9dc9dece13
Turner, Sally C.
7766b219-39e1-4504-8635-df0462904734
Mehta, Raj L.
00c133aa-709b-4483-b2ee-50b835a1b8a4
Mullee, Mark A.
fd3f91c3-5e95-4f56-8d73-260824eeb362

Bethell, Hugh J.N., Glover, Jason D., Evans, Julia A., Turner, Sally C., Mehta, Raj L. and Mullee, Mark A. (2008) The relationship between BNP and risk assessment in cardiac rehabilitation. British Journal of Cardiology, 15 (3), 161-165.

Record type: Article

Abstract

Risk stratification is important in the assessment of cardiac patients enrolled in physical training programmes but is often based on inadequate information. Measuring blood B-type natriuretic peptide (BNP) level, a marker of left ventricular dysfunction, might improve risk assessment. In an observational study blood BNP levels were measured in 100 consecutive patients joining a cardiac rehabilitation programme following acute myocardial infarction. The results were compared with the clinical risk assessment – high, moderate or low. There was a significant correlation between risk category (high, moderate or low) and BNP level (r=0.41, p=0.001). A BNP level of 100 pg/L or more gave a sensitivity of 89% (95% confidence interval [CI] 0.69, 0.97) and a specificity of 61% (95% CI 0.57, 0.63) for predicting high-risk patients with a positive predictive value of 33% (95% CI 0.26, 0.36) and a negative predictive value of 96% (95% CI 0.89, 0.99). A BNP level of less than 100 pg/ml gave a sensitivity of 78% (95% CI 0.55, 0.91) and a specificity of 54% (95% CI 0.43, 0.64) for predicting low-risk patients with a positive predictive value of 27% (95% CI 0.17, 0.40) and a negative predictive value of 92% (95% CI 0.80, 0.97). In conclusion, BNP levels provide information that may improve the accuracy of risk assessment of cardiac rehabilitation patients particularly when other information is limited.

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Published date: 2008
Organisations: Primary Care & Population Sciences

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Local EPrints ID: 338342
URI: https://eprints.soton.ac.uk/id/eprint/338342
ISSN: 0969-6113
PURE UUID: be3e6918-d36c-4aed-85f2-d4fa21b742ad

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Date deposited: 16 May 2012 09:29
Last modified: 18 Jul 2017 05:57

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