PT  - JOURNAL ARTICLE
AU  - Juan Antonio Mazzei
AU  - Juan Bourbotte
AU  - Marcelo Melero
AU  - Daniel Piñeiro
AU  - Griselda Pargament
AU  - Marcela Catro
TI  - Diagnostic accuracy of pleural fluid NTpro-BNP for pleural effusions of cardiac origin
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - 1691
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/1691.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/1691.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - INTRODUCTIONThe most frequent cause of a pleural effusion is heart failure. The diagnosis is based on clinical findings and biochemical parameters.RATIONALEThe existence of a specific heart biomarker could avoid unnecessary studies for the diagnosis of cardiac origin of pleural fluids.OBJECTIVEThe purpose of our study was to evaluate the diagnostic accuracy of pleural fluid aminoterminal fragment N-terminal pro-brain natriurético peptide (NTpro-BNP) for pleural effusions of cardiac origin compared with Framingham criteria.MATERIAL AND METHODSWe studied 32 consecutive patients admitted at the work site. Pleural and blood samples were simultaneously obtainedNTpro-BNP was measured in blood and pleural fluids (Bio Merieux® Enzyme-Linked Fluorescent Assay). Light criteria and serum-pleural albumin gradient was used to discriminate transudates from exudates.RESULTSThe cut-off value of pleural fluid NTpro-BNP level to discriminate between pleural effusions due to heart failure was ≥1.791 pg/mL. The sensitivity and specificity was 75.0%(95%CI 47.6-92.6) and 81.2%(95%CI 54.4-95.7) respectively; with a positive predictive value of 80.0%(95%CI 51.9-96.0), negative predictive value 81.8%(95%CI 50.1-93.2), positive likelihood ratio 4.0(95%CI 20.8-5.8) and negative likelihood ratio 0.3(95%CI 0.1-1.2).CONCLUSIONSPleural fluid NTpro-BNP is a very useful biomarker with high diagnostic accuracy for distinguishing pleural effusions of cardiac origin.