Point-of-care N-terminal pro B-type natriuretic peptide assay to screen apparently healthy cats for cardiac disease in general practice

J Vet Intern Med. 2021 Jul;35(4):1663-1672. doi: 10.1111/jvim.16156. Epub 2021 May 16.

Abstract

Background: Point-of-care (POC) N-terminal pro B-type natriuretic peptide (NT-proBNP) ELISA test has been evaluated for screening cats for cardiac disease in the referral veterinary setting but less is known about its use in general practice (GP).

Objectives: To evaluate the diagnostic utility of a POC NT-proBNP ELISA in cats seen in GPs.

Animals: Two hundred and seventeen apparently healthy cats from 21 GPs.

Methods: This was a prospective, cross-sectional study. Cardiac auscultation and POC NT-proBNP ELISA were done by veterinarians at their GPs. After enrollment at GPs, cats were sent to a cardiology referral hospital for cardiac auscultation and echocardiographic diagnosis. Results were interpreted based on whether cats had normal or abnormal echocardiographic findings.

Results: Point-of-care NT-proBNP ELISA results differentiated cats in the abnormal group from those in the normal group with a sensitivity of 43%, specificity of 96%. In cats with a heart murmur at GPs, POC NT-proBNP ELISA results differentiated cats in the abnormal group from those in the normal group with a sensitivity of 71% and a specificity of 92%.

Conclusion and clinical importance: In apparently healthy cats in GPs, positive POC NT-proBNP results are associated with heart disease, warranting an echocardiogram, but negative results do not reliably exclude heart disease. These results suggest POC NT-proBNP is not an effective screening test for apparently healthy cats in GPs, although its performance is improved if it is used only in cats that have a heart murmur.

Keywords: NT-proBNP; biomarker; feline; general practice; heart disease.

MeSH terms

  • Animals
  • Biomarkers
  • Cat Diseases* / diagnosis
  • Cats
  • Cross-Sectional Studies
  • General Practice*
  • Heart Diseases* / diagnosis
  • Heart Diseases* / veterinary
  • Heart Failure* / veterinary
  • Natriuretic Peptide, Brain
  • Peptide Fragments
  • Point-of-Care Systems
  • Prospective Studies

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain

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