Rev Esp Cardiol
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Multicenter Study
[Utility of NT-proBNP for diagnosing heart failure in a heterogeneous population of patients with dyspnea. Spanish multicenter study].
Recent studies have shown that brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are useful in the diagnosis of heart failure in patients presenting with dyspnea. However, the cutoff values used with these markers vary according to patient characteristics and dyspnea severity. The aim of this study was to investigate the diagnostic accuracy of using the plasma NT-proBNP level for identifying heart failure in a heterogeneous population of patients with dyspnea. ⋯ The plasma NT-proBNP concentration provides an accurate means of diagnosing heart failure. However, the negative predictive value found in this study was somewhat lower than the values found in previous studies involving more homogeneous patient populations.
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As patients who are Jehovah's Witnesses are against blood transfusion, they are difficult to manage when a cardiac intervention is required. Between 1998 and 2004, all Jehovah's Witness patients with an indication for cardiac surgery (n=10) were operated on by the same multidisciplinary team. The mean fall in hematocrit was 30% during cardiopulmonary bypass, 35% during the postoperative period, and 22% at discharge. ⋯ All patients survived operation and were discharged. At follow-up, 1 patient died due to respiratory failure. Technological developments that reduce bleeding and enable lost blood to be recovered have made it possible to perform operations involving a risk of hemorrhage in Jehovah's Witnesses.