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

Circ J. 2024 Apr 25;88(5):732-739. doi: 10.1253/circj.CJ-23-0930. Epub 2024 Mar 15.

Abstract

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.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.

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.

Keywords: B-type natriuretic peptide; Preclinical heart failure; Structural heart disease.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Early Diagnosis
  • Female
  • Heart Failure* / blood
  • Heart Failure* / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain* / blood
  • Primary Health Care*
  • Retrospective Studies

Substances

  • Natriuretic Peptide, Brain
  • Biomarkers