Assay-based automated blood test for B-type natriuretic peptide could reduce health service costs of congestive heart failure
Relieving congestion in cardiac departments Assay-based automated blood test for B-type natriuretic peptide could reduce health service costs of congestive heart failure An automated blood test for B-type natriuretic peptide (BNP) is now available to laboratories from Bayer Diagnostics, providing a valuable new tool for the diagnosis, prognosis and therapeutic management of congestive heart failure (CHF).
Elevated levels of BNP indicate the presence of heart failure.
When used to screen for early evidence of the development of CHF in the major 'at risk' population, BNP measurement has the potential to facilitate earlier recognition of CHF and improve the accuracy of diagnosis.
It also enables patients with no CHF to be ruled out, thus reducing the number of unnecessary echocardiograms and inappropriate drug therapy.
NHS managers are therefore being urged to include this assay in the range of laboratory tests available locally to clinicians, so that these benefits can be realised.
The management of CHF accounts for 2% of the NHS budget, about two-thirds of which are hospital costs.
5% of all medical admissions to hospital are related to the condition, and readmission rates have been estimated to be as high as 50% over three months.
About half of these admissions may be preventable according to the National Service Framework (NSF) for Coronary Heart Disease, which also acknowledges that many patients suffer from CHF that has not been recognised or appropriately treated. There is also evidence that some people who are treated do not have heart failure.
Bayer's BNP assay expands the already comprehensive cardiovascular test panel available for the Advia Centaur automated immunoassay system, comprising CK-MB, Myoglobin, Troponin I and Homocysteine.
Advia Centaur systems are used in many hospital laboratories throughout the UK, giving laboratory professionals the benefit of using a proven automated platform to report results in as little as 18 minutes.
The Advia Centaur BNP assay is a fully automated test which reduces the potential for human error by minimising the need for manual intervention.
Worldwide trials using the Advia Centaur BNP assay by cardiologists have established that when concentration of BNP is 100pg/mL the specificity of the test is greater than 96%.
When used as a diagnostic tool alongside physical examination, patient history and other non-invasive procedures, it can make a significant contribution to the differential diagnosis of CHF and the selection and monitoring of therapy.
The European Society of Cardiology has approved the use of BNP measurements as an aid in the screening and diagnosis of heart failure.
Several recent papers have endorsed the value of BNP measurement for use as a screening tool in the primary care setting.
The findings of one study indicate that BNP may be an excellent screening tool for left ventricular (LV) dysfunction, especially in the community where the greatest burden of disease exists and where there is limited access to echocardiography.
Another study described BNP as by far the most powerful marker for LV volumes amongst a range of neurohumoral substances tested, suggesting that BNP alone holds sufficient diagnostic power for implementation into clinical practice.
By authorising the addition of BNP to laboratory assay menus, trust managers can help to achieve delivery of the improved standards of patient care envisaged by the National Service Framework for Coronary Heart Disease. Availability of the test will not only benefit patients by facilitating earlier diagnosis of CHF, but also generate long-term cost savings by reducing demand for echocardiography and unnecessary therapy.
