BNP is supposed to be a very good test. It'll certainly help a lot of people. My husband has, in the past, been misdiagnosed with bronchitis, when he really had a very bad case of CHF, with serious lung consequences.
Here's some info on it.
"Press Release
SOURCE: Biosite Incorporated
New England Journal of Medicine Features Role of BNP Blood Test In The Emergency Diagnosis of Congestive Heart Failure
Circulation: Journal of the AHA Spotlights BNP's Ability To Reduce Clinical Uncertainty
SAN DIEGO, July 18 /PRNewswire-FirstCall/ -- Studies published in the July 18th issue of The New England Journal of Medicine and in the July 23rd Circulation: Journal of the American Heart Association support the value of B-type natriuretic peptide (BNP) in the diagnosis of congestive heart failure (CHF) and provide data supporting BNP's prevalent role in reducing the level of uncertainty among emergency department personnel in the diagnosis of congestive heart failure.
"In the study, BNP was the single most accurate predictor of congestive heart failure," said Alan Maisel, M.D., director of the coronary care unit at the San Diego VA Healthcare System and lead author of the New England Journal of Medicine study. "BNP performed better than both the National Health and Nutrition and Examination Survey (NHANES) and the Framingham criteria, arguably the current most accepted risk factor data for congestive heart failure diagnosis."
The publications relate to data compiled from a multi-center emergency department study that evaluated the diagnostic utility of BNP measurements in patients who were acutely short of breath. The study utilized the Triage® BNP Test, a rapid, point-of-care diagnostic tool developed by San Diego-based Biosite Incorporated (Nasdaq: BSTE - News). The blood test, which received FDA clearance in November 2000, achieved diagnostic accuracy of 83 percent, when used alone, without physician examination or traditional tests. This compares to a rate of 67 percent for NHANES criteria and 73 percent for the Framingham criteria.
"In today's busy emergency rooms, physicians are challenged to make fast and accurate diagnoses in order to ensure that patients receive appropriate treatment in a timely manner," said Maisel. "The study demonstrates that even without physician input, the BNP test offers a higher degree of correct and quick diagnosis."
In addition to evaluating accuracy, study investigators sought to determine the degree to which BNP adds to clinical judgment in the diagnosis of CHF. Emergency department physicians recorded the pre-test probability (clinical certainty) that the patient had CHF for 1,538 of the 1,586 participants who presented with acute shortness of breath (97 percent). A Bayesian analysis was used to determine the extent to which the BNP test contributed to an accurate diagnosis. The analysis revealed that physicians were clinically uncertain in their diagnosis of CHF in 43 percent of the patients. By augmenting clinical judgment with a BNP blood test at the point of care the clinical uncertainty was reduced to 11 percent.
"Significant indecision can accompany diagnosis, when physicians must rely on subjective or time consuming diagnostic methods. Reducing that uncertainty is a critical step in proper treatment, which may lead to cost efficiency and better patient outcomes," said Peter McCullough, M.D., M.P.H., chief of cardiology at the University of Missouri-Kansas City School of Medicine and lead author of the Circulation study. "We were able to show that this blood test is more efficient in correctly identifying congestive heart failure than all the conventional tools available to the physician in the emergency department," he added.
The study is the first prospective, blinded international multi-center study to definitively examine the use of BNP as a test to evaluate emergency room patients who are acutely short of breath. Of the patient population, 744 patients (47 percent) had a final diagnosis of CHF, 72 patients (5 percent) had a history of CHF but their shortness of breath was due to non- cardiac causes, and 770 patients (49 percent) did not have CHF. Two independent cardiologists, who were blinded to the BNP results, adjudicated these diagnoses.
The 1,586 patients recruited for the study ranged in age from 18-years-old to 105-years-old. Seven centers (two in Europe and five in the United States) participated in the study. Almost half of the patients were women; almost half were African-American, and about half were Caucasian.
Maisel concludes that BNP testing significantly adds to clinical judgment in diagnosing CHF. "Data support the use of this test for patients who present to emergency rooms with breathing problems and suspected congestive heart failure," said Maisel. "It appears that while blood tests for cardiac markers (creatine kinase, troponin I or myoglobin) have become essential to the diagnosis of a heart attack, the BNP blood test has now become integral to the diagnosis of CHF."
Drs. Maisel and McCullough are consultants to Biosite. The study was sponsored by Biosite.
About the Triage BNP Test
The Triage BNP Test is currently the only blood test used in hospitals to aid in the diagnosis of CHF. In approximately 15 minutes, the test measures circulating levels of BNP, which are elevated during heart dysfunction in both symptomatic (late-stage) and asymptomatic (early-stage) CHF patients. The portable test can be used in hospital emergency departments, clinical laboratories, and heart failure clinics to enable efficient and accurate diagnosis of patients who are experiencing shortness of breath or other symptoms associated with CHF.
Shortness of breath is a vague symptom common to a number of diseases. Critical time is spent trying to distinguish between non-cardiac and cardiac causes of this symptom. The Triage BNP Test can be performed at the point-of-care and offers rapid results, which allows CHF treatment to be administered in a timely manner.
Biosite secured a semi-exclusive license to BNP from Scios Inc. (Nasdaq: SCIO - News) in 1997. The license covers technology and patents for use in developing a test that aids in the diagnosis of CHF by measuring levels of BNP.
About Biosite
A leader in the drive to advance diagnosis, Biosite Incorporated is a research-based company dedicated to the discovery and development of novel protein-based diagnostic tests that improve a physician's ability to diagnose debilitating and life-threatening diseases.
The Company combines integrated discovery and diagnostics businesses to access proteomics research, identify proteins with high diagnostic utility, develop and commercialize products and educate the medical community on new diagnostic approaches that improve health care outcomes. Biosite's Triage® rapid diagnostic tests are used in approximately 50 percent of U.S. hospitals and in 40 international markets. Information on Biosite can be found at
www.biosite.com .
Except for the historical information presented herein, matters discussed in this press release are forward-looking statements that are subject to certain risks and uncertainties that could cause actual results to differ materially from any future results, performance or achievements expressed or implied by such statements. Statements that are not historical facts, including but not limited to statements that are preceded by, followed by, or that include the words "will"; "believes"; "should"; "intends"; "anticipates"; "plans"; "expects"; "estimates"; or similar statements are forward-looking statements. Risks and uncertainties include risks associated with sales, profitability, product discovery and development. Other risks that should be considered include, risks associated with expansion or development of a direct sales effort in domestic and international markets, and risks and expenses associated with litigation, contract disputes, patent conflicts, product recalls, manufacturing delays, shipment problems, seasonal customer demand, the timing of significant orders, changes in reimbursement policies, competitive pressures on average selling prices, changes in the mix of products sold, and the other risks detailed in the Company's Annual Report on Form 10-K, Quarterly Reports on Form 10-Q and other SEC filings. The Company disclaims, however, any intent or obligation to update these forward-looking statements. Copies of the Company's public disclosure filings are available from the investor relations department.
Biosite® and Triage® are registered trademarks of Biosite Incorporated. New Dimensions in Diagnosis(TM) and the Company's logo are trademarks or service marks of Biosite Incorporated.
SOURCE: Biosite Incorporated"
Gotta love versed. Vallium has never worked for me (makes me cranky instead), but this summer I got to try the "milk of amnisia" I'd heard so much about. I certainly am glad they have it. I love that I remember NOTHING from my last TEE, and just hope that this hospital will use the same drug (I plan to request it). And it starts working SO quickly...
