Diagnostic accuracy of N-terminal pro-brain natriuretic peptide for Kawasaki disease: An updated systematic review and meta-analysis

Int J Clin Pract. 2021 Nov;75(11):e14538. doi: 10.1111/ijcp.14538. Epub 2021 Jun 29.

Abstract

Objective: This study aimed to investigate the diagnostic accuracy of circulating N-terminal pro-brain natriuretic peptide (NT-proBNP) for Kawasaki disease (KD).

Methods: We searched the PubMed, Web of Science and EMBASE databases to identify the eligible studies investigating the diagnostic accuracy of NT-proBNP for KD. The revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2) was used to evaluate the eligible studies' quality. A meta-analysis was performed with the bivariate model and summary receiver operating characteristic (sROC) curve. We also performed subgroup, publication bias and sensitivity analyses.

Results: We included 12 studies with 2173 KDs and 1909 control. The pooled sensitivity and specificity of eligible studies were 0.80 (95%CI: 0.72-0.86) and 0.81 (95%CI: 0.73-0.88), respectively. The area under sROC curve was 0.88 (95%CI: 0.84-0.90). Patient selection bias and partial verification bias were the major design weakness of the eligible studies. Sensitivity analysis revealed that the results of this meta-analysis were robust. Subgroup analysis revealed that study design, NT-proBNP assay and participants' body temperature were not the source of heterogeneity across all eligible studies. No publication bias was observed.

Conclusion: NT-proBNP has moderate diagnostic accuracy for KD. It cannot be used for ruling in or ruling out KD when used alone.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biomarkers
  • Humans
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • Natriuretic Peptide, Brain
  • Peptide Fragments
  • ROC Curve
  • Sensitivity and Specificity

Substances

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