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===[[Special:MyLanguage/Brain natriuretic peptide (BNP)|Brain natriuretic peptide (BNP)]]<ref>Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.</ref>===<br />
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*Measurement<br />
**'''<100 pg/mL''': Negative for acute CHF (Sn 90%, NPV 89%)<br />
**'''100-500 pg/mL''': Indeterminate (Consider differential diagnosis and pre-test probability)<br />
**'''>500 pg/mL''': Positive for acute CHF (Sp 87%, PPV 90%)<br />
**Combination of BNP with clinician judgment 94% sensitive 70% specific (compared to 49% sn and 96% spec clinical judgement alone) <ref> McCullough et al. B-Type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from breathing not properly (BNP) multinational study. Circulation. 2002:DOI: 10.1161/01.CIR.0000025242.79963.4</ref><br />
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===[[Special:MyLanguage/NT-proBNP|NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===<br />
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*<300 pg/mL → [[Special:MyLanguage/CHF|CHF]] unlikely<br />
*[[Special:MyLanguage/CHF|CHF]] likely in:<br />
**'''>450 pg/mL''' in age < 50 years old<br />
**'''>900 pg/mL''' in 50-75 years old<br />
**'''>1800 pg/mL''' in > 75 years old</div>FuzzyBot