The Differential Diagnostic Value of Serum NT‐proBNP in Hospitalized Patients of Heart Failure With Pneumonia

Abstract

Serum N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) is considered as an effective predictor for patients with heart failure (HF), while a strong body of evidence has found its utility in inflammatory diseases. It is difficult to differentiate HF and HF coexisting with other inflammations by measuring NT‐proBNP. The aim of this study was to estimate the differential diagnostic performance of serum NT‐proBNP in hospitalized HF patients with pneumonia. A prospective study was launched. Sixty nine HF patients, 51 HF patients complicated with pneumonia, and 38 patients with pneumonia were enrolled. Serum NT‐proBNP levels were measured on Roche Elecsys. X‐ray and the European Society of Cardiology (ESC) diagnostic principles were adopted to identify patients with pneumonia and HF, respectively. The diagnostic performance of NT‐proBNP was assessed by ROC. Serum NT‐proBNP [7,039(1,008–24,672) pg/ml] in patients of HF complicated with pneumonia was significantly higher than that in those of patients with single HF [3,147(616–24,062) pg/ml] or single pneumonia [911(98–3,812) pg/ml] ( P < 0.0001). No correlation was found between the level of NT‐proBNP and hospital stay. The area under ROC curve (AUC) of NT‐proBNP for distinguishing patients of HF with pneumonia was 0.8082. At the level of 4,691 pg/ml, the optimal cutoff value, 74.5% sensitivity and 81.8% specificity of NT‐proBNP were predicted. Evaluation of serum NT‐proBNP is conducive for clinicians to identify patients of HF with pneumonia, but its poor efficacy in monitoring the curative therapy in this entire cohort is not recommended.