Emergency room use of a blood test for N-Terminal proB-type natriuretic peptide helps to promptly identify patients with acute decompensated heart failure, according to a late-breaking clinical trial presented at the American Heart Association meeting.

The N-Terminal proB-type Natriuretic Peptide Improves the Management of Patients with Suspected Acute Decompensated Heart Failure: Primary Results of the Canadian Multicenter IMPROVE-CHF Study was designed to evaluate clinical use of blood testing for the biomarker associated with acute decompensated heart failure (ADHF), said Gordon W. Moe, MD, principal investigator of the study and a cardiologist and director of the heart failure program and biomarker laboratory at St. Michael’s Hospital in Toronto, Canada.

The phase IV study of Canadian patients presenting with dyspnea and suspected decompensated heart failure involved 501 patients (median age, 75 years; 52 percent male) who were evaluated at seven Canadian emergency departments.

Physicians immediately committed to a diagnosis for each patient based on their professional judgment. Diagnoses were later judged and confirmed by cardiologists blinded to each patient’s test results, which were measured in the emergency room and again 72 hours following admission for patients who were hospitalized.

The patients were then randomized to either usual care or care guided by the test results.

The median natriuretic peptide level in the 227 patients with final diagnoses of acute decompensate heart failure was 3,717 picograms per milliliter (pg/ml) of blood compared with 340 pg/ml in patients with other final diagnoses.

At 60 days of follow-up, 114 subjects (23 percent) had died or were hospitalized, with no difference between groups for that combined endpoint.

In analyzing their data, the researchers found that every 10-fold increase in peptide level in the emergency department was associated with a 41-percent increase in the 60-day combined risk of death or rehospitalization.