J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 3, Number 4, August 2011, pages 156-163

Validity of Amino Terminal pro-Brain Natiuretic Peptide in a Medically Complex Elderly Population

Figure 1.. Test PerformanceArea Under the Receiver Operator Curve (ROC) Characteristics for Total Population. Median NT-proBNP for total cohort: 3050 pg/ml; Median NT-proBNP for CHF group: 4935 pg/ml; Median NT-proBNP for non-CHF group: 1075 pg/ml. CHF: Congestive Heart Failure.

Figure 2.. Test performance-area under the receiver operator curve (ROC) characteristics for age 50 or ≥ 50 years.

Figure 3.. Test performance-area under the receiver operator curve (ROC) characteristics for hematocrit.

**Table 1.** Demographics and Clinical Characteristics in the Entire Cohort
	Total (%)	(-) CHF (%)	(+) CHF (%)	p-value
CHF: congestive heart failure; MI: myocardial infarction; PTCA: percutaneous coronary intervention; CABG: coronary artery bypass grafting; COPD: chronic obstructive pulmonary disease; PE: pulmonary embolus; ACE-I: angiotensin converting enzyme inhibitor; ARB: angiotensin receptor blocker; eGFR: estimated glomerular filtration rate. P value compares those with and without a final diagnosis of CHF.
Demographics
Age (years) (mean/range)	71 ± 15.1	70	73	0.05
Men (%)	45	46	45	0.78
Caucasian (%)	73	73	74	0.9
Symptoms/Signs
Chest pain	22	23	22	0.8
Cough	17	20	15	0.16
Edema	9	6	11	0.03
Fever	7	7	7	0.88
Medical History
Prior CHF	42	20	56	< 0.0001
Prior MI	19	11	24	< 0.001
Valvular Heart Disease	13	8	17	0.001
Coronary Artery Disease	37	29	42	< 0.01
Prior CABG/PCI	20	14	24	< 0.01
COPD/Prior PE	17	17	17	0.99
Systemic Hypertension	63	60	65	0.28
Diabetes Mellitus	36	29	40	0.01
Smoking History	18	19	17	0.44
Medications
Spirinolactone	8	2	13	< 0.0001
Digoxin	17	10	22	< 0.001
Beta blocker	40	29	47	< 0.001
ACE-I/ARB	43	34	49	< 0.001
Loop diuretic	43	25	55	< 0.001
Other
Hematocrit < 30	21	16	24	0.05
eGFR < 30	16	14	17	0.45

Table 1. Demographics and Clinical Characteristics in the Entire Cohort

Total (%)

(-) CHF (%)

(+) CHF (%)

p-value

CHF: congestive heart failure; MI: myocardial infarction; PTCA: percutaneous coronary intervention; CABG: coronary artery bypass grafting; COPD: chronic obstructive pulmonary disease; PE: pulmonary embolus; ACE-I: angiotensin converting enzyme inhibitor; ARB: angiotensin receptor blocker; eGFR: estimated glomerular filtration rate. P value compares those with and without a final diagnosis of CHF.

Demographics

Age (years)
(mean/range)

71 ± 15.1

0.05

Men (%)

0.78

Caucasian (%)

0.9

Symptoms/Signs

Chest pain

0.8

Cough

0.16

Edema

0.03

Fever

0.88

Medical History

Prior CHF

< 0.0001

Prior MI

< 0.001

Valvular Heart Disease

0.001

Coronary Artery Disease

< 0.01

Prior CABG/PCI

< 0.01

COPD/Prior PE

0.99

Systemic Hypertension

0.28

Diabetes Mellitus

0.01

Smoking History

0.44

Medications

Spirinolactone

< 0.0001

Digoxin

< 0.001

Beta blocker

< 0.001

ACE-I/ARB

< 0.001

Loop diuretic

< 0.001

Other

Hematocrit < 30

0.05

eGFR < 30

0.45

**Table 2.** Analysis Based on the ICON Trial Cut-offs
Cutoff Value Age (years) NT-proBNP	Sensitivity (%)	Specificity (%)	Positive Predictive Value (%)	Negative Predictive Value (%)	Diagnostic Accuracy (%)
ICON: International Collaborative of NT-proBNP
<50 years 450 pg/ml	94	45	72	82	65
50-75 years 900 pg/ml	80	56	69	70	67
>75 years 1800 pg/ml	79	52	75	59	70
Cumulative Data	81	53	72	66	70

Table 2. Analysis Based on the ICON Trial Cut-offs

Cutoff Value
Age (years)
NT-proBNP

Sensitivity (%)

Specificity (%)

Positive Predictive Value (%)

Negative Predictive Value (%)

Diagnostic Accuracy (%)

ICON: International Collaborative of NT-proBNP

<50 years 450 pg/ml

50-75 years 900 pg/ml

>75 years 1800 pg/ml

Cumulative Data