Influence of age, race, sex, and body mass index on interpretation of midregional pro atrial natriuretic peptide for the diagnosis of XXXX : results from the BACH multinational study.

@entity1 @entity712
AIMS: Midregional pro atrial natriuretic peptide (MR-proANP) is useful for diagnosing @entity712 (HF) in @entity1 presenting to the Emergency Department with dyspnoea. Optimal interpretation of MR-proANP requires understanding of how various demographic variables influence its levels and performance as a diagnostic marker. We sought to determine how age, race, sex, and body mass index (BMI) affect the levels and interpretation of MR-proANP for the diagnosis of acute HF. METHODS AND RESULTS: The Biomarkers in @entity712 (BACH) study was an international 15-centre study of 1641 @entity1 presenting to the Emergency Department with acute dyspnoea. Of these, 1352 had complete information on age, race, sex, and BMI. MR-proANP levels increased with age and were higher in @entity1 and in @entity1 with lower BMI. MR-proANP performed better as a diagnostic marker in younger individuals and in blacks compared with whites. Despite this, MR-proANP at the recommended cut-off point of 120 pmol/L was >90 % sensitive in ruling out the diagnosis of acute HF in all subgroups of @entity1 except white subjects <50 years old. CONCLUSION: Age, race, sex, and BMI affect MR-proANP levels to various degrees. However, the diagnostic performance of the recommended cut-off point of 120 pmol/L to rule out acute HF was robust across most subgroups. Although both sex and BMI affected MR-proANP levels, they did not alter its overall diagnostic performance. Lower cut-off points for MR-proANP could be considered in younger @entity1 and in @entity1 with a higher BMI, to optimize diagnostic sensitivity.
