Abstract
Background
B-type natriuretic peptide (BNP) is used to diagnose heart failure (HF).
Objective
To compare the accuracy of two commercially available point-of-care (POC) devices
for measuring B-type natriuretic peptide (BNP) in emergency department (ED) patients
with suspected heart failure using the central laboratory testing results as the criterion
standard.
Methods
Venous blood samples were collected from adults with suspected heart failure and split
into three samples for BNP analysis: central laboratory (Siemens ADIVA Centaur; Siemens,
Deerfield, IL), Triage BNP POC device (Biosite, San Diego, CA), and i-STAT BNP POC
device (Abbott, East Windsor, NJ). The criterion standard for BNP levels was the central
laboratory.
Results
Two hundred fifty patients were enrolled. Mean (SD) age was 70.7 (13.8) years; 200
(80%) were over age 55 years; 146 (58.4%) were male. A final hospital discharge diagnosis
of heart failure was made in 108 (42%) patients. The i-STAT system yielded a result
within a median of 9 min (interquartile range [IQR] 9–10 min). The Triage device yielded
a result within a median of 19 min (IQR 15–22 min); p < 0.001. The device failure rate for the central laboratory (8 failures, 3.2%) was
significantly higher than that of the i-STAT device (1 failure, 0.4%, p = 0.04), but not statistically different than the Triage device (3 failures, 1.2%).
Neither the Triage nor the i-STAT were statistically different than the central laboratory
result in terms of sensitivity; the i-STAT was less specific than the Triage result
(p = 0.003). The area under the curve for the Triage device was 0.95 (95% confidence
interval [CI] 0.91–0.98), whereas the area under the curve for the i-STAT device was
0.98 (95% CI 0.96–0.99; p < 0.01).
Conclusions
Both POC devices tested were accurate and rarely failed; however, the i-STAT was faster
with single use.
Keywords
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Article info
Publication history
Published online: May 27, 2011
Accepted:
October 31,
2010
Received in revised form:
October 18,
2010
Received:
May 11,
2010
Footnotes
This study was funded by Biosite Inc., San Diego, CA.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
