Skip to main content

Table 2 Diagnostic accuracy of NT-proBNP as rule-out test for LV dysfunction (types as specified)*

From: Utility of NT-proBNP as a rule-out test for left ventricular dysfunction in very old people with limiting dyspnoea: the Newcastle 85+ Study

  Prevalence of specified LV dysfunction % (n) AUC (95% CI) NT-proBNP cut point (ng/l) Sensitivity % Specificity % PPV % NPV % % of participants at or above cut point (echo warranted) Number of cases picked up per 100 screened Number of cases missed per 100 screened Number of false positives per 100 screened
Systolic dysfunction, any grade (LVEF≤50%) 34.2 (53) 0.58 (0.49-0.65)          
ESC guideline rule-out cut point, 125ng/l    125 98.1 14.7 37.4 93.8 87.7 33.5 0.6 56.1
NICE guideline rule-out cut point, 400ng/l    400 54.7 50.0 36.3 68.0 51.0 18.7 15.5 32.9
Data-derived 'stringent' rule-out cut point (closest to 95% sensitivity)    131 96.2 16.7 37.5 89.5 87.7 32.9 1.3 54.8
Data-derived 'optimised' rule-out cut point (highest sensitivity with specificity at least 50%)    380 56.6 50.0 37.0 68.9 52.3 19.3 14.8 32.9
Moderate/severe systolic dysfunction (LVEF≤40%) 8.4 (13) 0.80 (0.73-0.86)          
ESC guideline rule-out cut point, 125ng/l    125 100.0 11.3 9.4 100.0 87.7 8.4 0.0 81.2
NICE guideline rule-out cut point, 400ng/l    400 84.6 51.4 13.8 97.3 51.0 7.1 1.3 44.5
Data-derived 'stringent' rule-out cut point (closest to 95% sensitivity)    197 100.0 26.8 11.1 100.0 75.5 8.4 0.0 67.1
Data-derived 'optimised' rule-out cut point (highest sensitivity with specificity at least 50%)    363 84.6 50.0 13.4 97.3 52.9 7.1 1.3 45.8
Systolic dysfunction (any grade) OR isolated moderate/severe diastolic dysfunction 53.5 (83) 0.64 (0.56-0.72)          
ESC guideline rule-out cut point, 125ng/l    125 95.2 16.7 56.8 75.0 87.7 50.9 2.6 38.7
NICE guideline rule-out cut point, 400ng/l    400 60.2 58.3 62.5 56.0 51.0 32.3 21.3 19.4
Data-derived 'stringent' rule-out cut point (closest to 95% sensitivity)    120 95.2 16.7 56.8 75.0 89.7 50.9 2.6 38.7
Data-derived 'optimised' rule-out cut point (highest sensitivity with specificity at least 50%)    319 63.9 51.4 60.2 55.2 56.8 34.2 19.4 22.6
Moderate/severe systolic dysfunction OR isolated moderate/severe diastolic dysfunction 27.7 (43) 0.71 (0.63-0.78)          
ESC guideline rule-out cut point, 125ng/l    125 93.0 11.6 28.8 81.3 87.7 25.8 1.9 63.9
NICE guideline rule-out cut point, 400ng/l    400 74.4 57.1 40.0 85.3 51.0 20.6 7.1 31.0
Data-derived 'stringent' rule-out cut point (closest to 95% sensitivity)    113 95.3 11.6 29.3 86.7 90.3 26.5 1.3 63.9
Data-derived 'optimised' rule-out cut point (highest sensitivity with specificity at least 50%)    298 79.1 50.0 37.8 86.2 58.1 21.9 5.8 36.1
  1. *Abbreviations: AUC area under curve, PPV positive predictive value, NPV negative predictive value, ESC European Society of Cardiology, NICE National Institute for Health and Care Excellence.
  2. Detailed legend: Diagnostic accuracy of NT-proBNP as rule-out test for LV dysfunction (types as specified) at range of guideline recommended and data-derived rule-out cut points.