Table of Contents
ISRN Family Medicine
Volume 2013, Article ID 273864, 5 pages
http://dx.doi.org/10.5402/2013/273864
Clinical Study

Using NT-proBNP to Detect Chronic Heart Failure in Elderly Patients with Chronic Obstructive Pulmonary Disease

1Blekinge Competence Centre, Wämö Centre, 371 81 Karlskrona, Sweden
2Lund University, Department of Clinical Sciences in Malmö, General Practice/Family Medicine, 205 02 Malmö, Sweden
3Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, 5000 Odense C, Denmark

Received 25 April 2013; Accepted 28 May 2013

Academic Editors: A. M. Salinas-Martinez and A. Vellinga

Copyright © 2013 Elzbieta Kaszuba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To detect chronic heart failure in elderly patients with a registered diagnosis of chronic obstructive pulmonary disease (COPD) treated in Swedish primary health care using natriuretic peptide NT-proBNP. Design. A cross-sectional study. Setting. Two primary health care centres in southeastern Sweden each with about 9000 listed patients. Subjects. Patients aged 65 years and older with a registered diagnosis of COPD. Main Outcome Measures. Percentage of patients with elevated NT-proBNP, percentage of patients with abnormal left ventricular function assessed by echocardiography, and association between elevated NT-proBNP and symptoms, signs, and electrocardiography. Results. Using NT-proBNP threshold of 1200 pg/mL, we could detect and confirm chronic heart failure in 5.6% of the study population with concurrent COPD. An elevated level of NT-proBNP was only associated with nocturia and abnormal electrocardiography. Conclusions. We found considerably fewer cases of heart failure in patients with COPD than could be expected from the results of previous studies. Our study shows the need for developing improved strategies to enhance the validity of a suspected heart failure diagnosis in patients with COPD.