Article Figures & Data
Figures
- Figure 1. Flowchart of the study population. HF = heart failure. NP = natriuretic peptide
- Figure 2. Overview of diagnostic actions taken by GPs in 394 patients with an elevated natriuretic peptide level.
BNP = B-type natriuretic peptide. ECG = electrocardiogram. HF = heart failure. ICPC = International Classification of Primary Care. NP = natriuretic peptide
Tables
- Table 1. Patient characteristics of 394 individuals with an elevated natriuretic peptide level, subdivided in those referred and those not referred for echocardiography
Referred n = 166 Not referred n = 228 P value Median age in years (IQR) 73±21.8 78±17.3 <0.001 Median NT-proBNP in pg/ml (IQR) 400.0±348.0 219.0±193.8 0.104 Median BNP in pg/ml (IQR) 83.0±86.0 63.0±83.0 <0.001 Female 121 (72.9) 150 (65.8) 0.164 Mean BMI in kg/m2 (SD) (n = 320) 29.7±6.7 28.1±5.2 0.024 Mean SBP in mmHg (SD) (n = 385) 135.3±17.5 135.2±19.3 0.938 Mean DBP in mmHg (SD) (n = 385) 80.3±12.1 78.6±10.9 0.154 Smoking ( n = 307), n (%) Never
Past
Current68 (52.7)
50 (38.8)
11 (8.5)90 (50.6)
76 (42.7)
12 (6.7)0.798
0.566
0.714Comorbidities n (%) Anaemia 24 (14.5) 35 (15.4) 0.919 Angina pectoris 22 (13.3) 27 (11.8) 0.791 Prior myocardial infarction 10 (6.0) 34 (14.9) 0.009 PCI or CABG 9 (5.4) 11 (4.8) 0.972 Atrial fibrillation 34 (20.5) 51 (22.4) 0.745 Valvular heart disease 16 (9.6) 21 (9.2) 1.00 Hypertension 95 (57.2) 129 (56.6) 0.980 COPD 14 (8.4) 33 (14.5) 0.095 Type 2 diabetes 37 (22.3) 53 (23.2) 0.919 Dyslipidaemia 30 (18.1) 39 (17.1) 0.908 Chronic kidney disease 36 (21.7) 63 (27.6) 0.220 Participation in integrated PC disease management programme n (%) Total 103 (62.0) 153 (67.1) 0.351 COPD programme 7 (4.2) 14 (6.1) 0.540 Type 2 diabetes programme 32 (19.3) 50 (21.9) 0.607 CVRM programme 69 (41.6) 101 (44.3) 0.662 Blood test values n (%) eGFR<60 ml/min/1.73 m2 (n = 388) 32 (19.9) 60 (26.4) 0.169 HF suggestive symptoms Shortness of breath 92 (55.4) 105 (46.1) 0.083 Reduced exercise tolerance and/or fatigue 74 (44.6) 75 (32.9) 0.024 Orthopnoea and/or nocturnal dyspnoea 19 (11.4) 14 (6.1) 0.090 Nocturia 21 (12.7) 28 (12.3) 1.00 Peripheral oedema 68 (41.0) 90 (39.5) 0.846 HF suggestive signs Pulmonary crackles 24 (14.5) 26 (11.4) 0.456 Peripheral oedema 53 (31.9) 73 (32.0) 1.00 Data presented as mean±standard deviation (SD), median±interquartile range (IQR), or absolute count (%). BMI = body mass index. CABG = coronary artery bypass graft surgery. COPD = chronic obstructive pulmonary disease. CVRM = cardiovascular risk management. DBP = diastolic blood pressure. eGFR = estimated glomerular filtration rate. HF = heart failure. NT-proBNP = N-terminal pro-B-type natriuretic peptide. PC = primary care. PCI = percutaneous coronary intervention. SBP = systolic blood pressure.
- Table 2. Potential factors affecting the GP's decision on referral for echocardiography in patients with an elevated natriuretic peptide level
n (%) Referred n = 166 Not referred n = 228 P value BNP slightly elevated (35–50 pg/ml) 31/161 (19.3) 79/216 (36.6) <0.001 NT-proBNP slightly elevated (125–300 pg/ml) 2/5 (40.0) 8/12 (66.7) 0.593 Abnormal ECG 45 (70.3) 19 (38.0) 0.002 Known to cardiologist before NP testing 76 (45.8) 142 (62.3) 0.002 Telephone contact with cardiologist after NP testing 31 (18.7) 29 (12.7) 0.138 Data presented as absolute count (%). ECG = electrocardiogram. NT-proBNP = N-terminal pro-B-type natriuretic peptide. NP = natriuretic peptide
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