Diagnostic value of cardiac natriuretic peptide on pulmonary hypertension in systemic sclerosis: A systematic review and meta-analysis - 18/02/22
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Highlights |
• | Cardiac natriuretic peptides are often elevated in systemic sclerosis secondary pulmonary arterial hypertension (SSc-PAH) patients and are considered as useful markers for PAH. |
• | We summarized diagnostic evidence of B-type natriuretic peptide (BNP)/N-terminal pro-BNP (NT-proBNP) for SSc-PAH and evaluate their clinical application value. |
• | The meta-analysis included 9 studies involving 479 patients. |
• | NT-proBNP has certain diagnostic value for PAH due to its better specificity and moderate sensitivity. |
Abstract |
Objective |
Pulmonary arterial hypertension (PAH) is a major cause of morbidity and mortality in systemic sclerosis (SSc). Many risk factors and predictors of outcomes have been identified in these patients. B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) serum levels are often elevated in SSc patients with early PAH. We conducted this systematic review and meta-analysis to estimate the diagnostic value of BNP/NT-proBNP in systemic sclerosis secondary pulmonary arterial hypertension (SSc-PAH).
Methods |
A systematic search was performed through PubMed, Embase, and Cochrane Library databases up to January 30, 2021. Stata 16.0 (Stata Corp, College Station, TX) was used to conduct the meta-analysis.
Results |
A total of 9 studies involving 220 SSc-PAH patients and 259 non-SSc-PAH controls were included. The values of sensitivity and specificity using BNP and NT-ProBNP as diagnostic tools were pooled in the diagnostic meta-analysis. The overall performance of BNP/NT-ProBNP detection was: pooled sensitivity, 0.67 (95% CI: 0.52 to 0.79); pooled specificity, 0.84 (95% CI: 0.75 to 0.91); pooled positive likelihood ratio, 4.3 (95% CI: 3 to 6.1); and pooled negative likelihood ratio, 0.39 (95% CI: 0.28 to 0.55). The subgroup analysis showed similar results. Funnel plots indicate that there is no evidence for publication bias.
Conclusions |
Our results revealed that NT-proBNP has certain diagnostic value for PAH due to its better specificity and moderate sensitivity, but its clinical application value remains suboptimal and can not be a stand-alone decision-making diagnostic tool of SSc-PAH.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Systemic sclerosis, Pulmonary arterial hypertension, Cardiac natriuretic peptide, Diagnostic value, Systematic review
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Vol 89 - N° 2
Articolo 105287- Marzo 2022 Ritorno al numero
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