What Are the Screening Performance Characteristics of BNP or NT-proBNP in General Asymptomatic Populations?
In general, a test is considered important to utilize as a screening tool if the burden of suffering is high, the test itself is accurate and if early detection of the disease with the test is an effective intervention such that mortality/morbidity is reduced for those that were screened. In the studies that used BNP as the index test, adequate screening characteristics were not observed, and this is true even for the detection of moderate to severe LVSD. It is even less accurate for detection of milder degrees of systolic dysfunction, which is more common in the general population. BNP is also quite poor for the detection of diastolic dysfunction. One requirement for screening is that there is evidence that early detection and intervention reduces morbidity and mortality. This evidence cannot be provided for BNP since it fails to detect those with milder degrees of systolic dysfunction who are known to be at increased risk. A single study using NT-proBNP as the index test with Danish
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