Using POC BNP to rule out Heart failure

A meta analysis was recently done to assess the diagnostic accuracy of POC BNP testing in patients with chronic heart failure, especially in an ambulatory setting. This was against any relevant standard of care interventions like ECHO, clinical examination or combination of both.

At thresholds of >100 pg/ml the sensitivity of BNP was 0.95. At levels <100, it ranged from 0.46 to 0.97 and specificity of 0.31 to 0.98.

So what this means is, the ability to rule out Heart failure using POC BNP has a better sensitivity with a cutoff of atleast 100 pg/ml rather than using it to rule in heart failure.

LOE = 1a

Taylor KS, Verbakel JY, Feakins BG, et al. Diagnostic accuracy of point-of-care natriuretic peptide testing for chronic heart failure in ambulatory care: systematic review and meta-analysis. BMJ 2018;361:k1450.