Diagnostic accuracy of N‐terminal pro‐brain natriuretic peptide for Kawasaki disease: an updated systematic review and meta‐analysis

2021 ◽  
Author(s):  
Jian‐Xun Wen ◽  
Xue Bai ◽  
Yan Niu ◽  
Zhi‐De Hu
Keyword(s):  
Systematic Review ◽  
Kawasaki Disease ◽  
Diagnostic Accuracy ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Meta Analysis

scholarly journals Protocol for A Systematic Review and Meta-Analysis of Studies on the Use of Brain Natriuretic Peptide and N-Terminal Brain Natriuretic Peptide Levels in the Diagnosis of Cardiopulmonary Edema in Acute Respiratory Failure

2020 ◽  
Author(s):  
Takero Terayama ◽  
Takuya Taniguchi ◽  
Ryosuke Imai ◽  
Keisuke Anan ◽  
Takuo Yoshida ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Diagnostic Accuracy ◽  
Brain Natriuretic Peptide ◽  
Pulmonary Edema ◽  
Diagnostic Test ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Test Accuracy

Abstract Background Dyspnea with bilateral pulmonary edema is common among patients in emergency departments (EDs) or intensive care units (ICUs). For the initial management of patients with this condition, cardiopulmonary edema (CPE) must be differentiated from acute respiratory distress syndrome (ARDS) in clinical settings. Brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) are useful in distinguishing these conditions. However, current data about the use of these indexes are limited. Hence, we planned to perform a systematic review and meta-analysis to determine the accuracy of the two indexes for the diagnosis of CPE.Methods We designed and registered a study protocol for a systematic review and meta-analysis. This study aims to determine the diagnostic accuracy of BNP and NT-proBNP based on the standards of the methodology of the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy and the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies in reporting the findings of this review. We will search PubMed (MEDLINE), Cochrane Library, www.clinicaltrials.gov, and International Clinical Trials Registry Platform. Randomized controlled trials and observational cohort studies reporting the accuracy in diagnosing CPE among adult patients with dyspnea and bilateral pulmonary edema will be included in the analysis. Two reviewers will independently screen articles, extract data, and evaluate for quality and bias using the Quality Assessment of Diagnostic Accuracy Studies. Then, a meta-analysis will be performed, and different statistical methods will be used to investigate heterogeneity among studies. A subgroup analysis of elderly patients with left ventricular dysfunction or chronic renal dysfunction will be performed. In the meta-analysis, a hierarchical summary receiver operating characteristic model or a bivariate model will be used in each index test, as appropriate.Discussion A systematic review and meta-analysis of the accuracy of BNP and NT-proBNP for the diagnosis of CPE will be conducted. The result of this study can help clinicians to identify an appropriate initial treatment for patients with acute respiratory failure, including those with ARDS and CPE. To the best of our knowledge, this will be the first comprehensive systematic review focusing on ARDS management in a specific population.Systematic review registrationUMIN-CTR ID: UMIN000040983.

scholarly journals Protocol for a systematic review and meta-analysis of studies on the use of brain natriuretic peptide and N-terminal brain natriuretic peptide levels in the diagnosis of cardiopulmonary edema in acute respiratory failure

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Takero Terayama ◽  
Takuya Taniguchi ◽  
Ryosuke Imai ◽  
Keisuke Anan ◽  
Takuo Yoshida ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Diagnostic Accuracy ◽  
Brain Natriuretic Peptide ◽  
Pulmonary Edema ◽  
Diagnostic Test ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Test Accuracy

Abstract Background Dyspnea with bilateral pulmonary edema is common among patients in emergency departments (EDs) or intensive care units (ICUs). For the initial management of patients with this condition, cardiopulmonary edema (CPE) must be differentiated from acute respiratory distress syndrome (ARDS) in clinical settings. Brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) are useful in distinguishing these conditions. However, current data about the use of these indexes are limited. Hence, we planned to perform a systematic review and meta-analysis to determine the accuracy of the two indexes for the diagnosis of CPE. Methods We designed and registered a study protocol for a systematic review and meta-analysis. This study aims to determine the diagnostic accuracy of BNP and NT-proBNP based on the standards of the methodology of the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy and the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies in reporting the findings of this review. We will search PubMed (MEDLINE), Cochrane Library, Embase, www.ClinicalTrials.gov, International Clinical Trials Registry Platform, and Google Scholar. Randomized controlled trials, cross-sectional studies, and observational cohort studies reporting the accuracy in diagnosing CPE among adult patients with dyspnea and bilateral pulmonary edema will be included in the analysis. There will be no limits regarding language and publication date for this review. Two reviewers will independently screen articles, extract data, evaluate for quality and bias using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), and use Grading of Recommendations Assessment, Development and Evaluation to summarize the strength of body of evidence. Then, a meta-analysis will be performed, and different statistical methods will be used to investigate heterogeneity among studies. A subgroup analysis of elderly patients with left ventricular dysfunction or chronic renal dysfunction will be performed. In the meta-analysis, a hierarchical summary receiver operating characteristic model or a bivariate model will be used in each index test, as appropriate. Discussion A systematic review and meta-analysis of the accuracy of BNP and NT-proBNP for the diagnosis of CPE will be conducted. The result of this study can help clinicians to identify an appropriate initial treatment for patients with acute respiratory failure, including those with ARDS and CPE. To the best of our knowledge, this will be the first comprehensive systematic review focusing on ARDS management in a specific population. Systematic review registration PROSPERO ID CRD42020201576

scholarly journals Efficacy and Safety of TCMI in Patients With Combined Coronary Heart Disease and Heart Failure: A Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Penglu Wei ◽  
Kuo Yang ◽  
Dehuai Long ◽  
Yupei Tan ◽  
Wenlong Xing ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Effectiveness Rate

Objective: To compare the efficacy and safety of conventional treatments (CTs) to those that included traditional Chinese medicine injections (TCMIs) in patients with combined coronary heart disease and heart failure (CHD-HF).Methods: Eight electronic literature databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure Database, Chinese Scientific Journal Database, Wanfang Database, Chinese Biomedical Database) were searched from their inceptions to May 18, 2021, to identify relevant randomised controlled trials (RCTs). The primary outcomes analyzed included the total effectiveness rate and adverse events (ADRs). The secondary outcomes analyzed included the left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP), brain natriuretic peptide (BNP), and 6-min walk test (6MWT). Cochrane risk-of-bias tool was used to assess quality of the analyzed RCTs. Stata and OpenBUGS software were used to prior to the systematic review and network meta-analysis.Results: Sixty-one eligible trials involved 5,567 patients and one of the following 15 TCMIs: Shuxuetong, Shenmai, Shenfu, Shengmai, Danshenduofenyansuan, Danhong, Dazhuhongjingtian, Xinmailong, Dengzhanxixin, Gualoupi, Shuxuening, Xuesaitong, Yiqi Fumai, Shenqi Fuzheng, Huangqi. Network meta-analysis revealed that Shuxuetong injection + CT group was superior to CT only in improving the total effectiveness rate [odds ratio (OR): 7.8, 95% confidence interval (CI): 1.17–27.41]. Shenmai injection + CT was superior to CT only for LVEF (OR: 8.97, CI: 4.67–13.18), Xinmailong injection + CT was superior to CT only for NT-proBNP (OR: −317.70, CI: −331.10–303.10), Shenqi Fuzheng injection + CT was superior to CT only for BNP (OR: −257.30, CI: −308.40–242.80); and Danhong injection + CT was superior to CT only for 6MWT (OR: 84.40, CI: 62.62−106.20). Different TCMIs had different toxicity spectrums.Conclusion: TCMIs combined with CT are better than CT alone in treating CHD-HF. Different TCMIs improve different outcomes. Additional properly designed RCTs are needed to conduce a more refined comparison of various TCMIs.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021258263].

scholarly journals Brain Natriuretic Peptide to Predict Successful Liberation from Mechanical Ventilation in Critically Ill Patients: a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Jean Deschamps ◽  
Sarah K. Andersen ◽  
Jordan Webber ◽  
Robin Featherstone ◽  
Meghan Sebastianski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Brain Natriuretic Peptide ◽  
Critically Ill ◽  
Natriuretic Peptide ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Spontaneous Breathing Trial ◽  
Clinical Criteria ◽  
Alternate Test

Abstract Background: Predicting successful liberation from mechanical ventilation (MV) in critically ill patients is challenging. Brain natriuretic peptide (BNP) has been proposed to help guide decision-making for readiness to liberate from MV following a spontaneous breathing trial (SBT). Methods : We performed a systematic review and meta-analysis of randomized and prospective observational studies that measured BNP levels at the time of SBT in patients receiving MV. The primary endpoint was successful liberation from MV (absence of re-intubation or non-invasive ventilation at 48h). Statistical analyses included bi-variate and Moses-Littenberg models, and DerSimonian-Laird pooling of areas under ROC curve (AUROC). Results: A total of 731 articles were screened. Eighteen adult and 2 pediatric studies were fulfilled pre-specified eligibility. The measure of the relative variation of BNP during SBT (DBNP%) after exclusion of SBT failure by clinical criteria in adults yielded a sensitivity and specificity of 0.889 [0.831-0.929] and 0.828 [0.730-0.896] for successful liberation from MV respectively, with a pooled AUROC of 0.92 [0.88-0.97]. The pooled AUROC for any method of analysis for absolute variation of BNP (DBNP), pre-SBT BNP and post-SBT BNP were 0.89 [0.83-0.95], 0.77 [0.63-0.91], and 0.85 [0.80-0.90], respectively.Conclusion: The relative change in BNP during a SBT has potential value as an incremental tool after successful SBT to predict successful liberation from MV in adults. There is insufficient data to support the use of BNP in children or as an alternate test to clinical indices of SBT or the use of DBNP, BNP-pre and BNP-post as an alternate or incremental test.Trial registration number: PROSPERO CRD42018087474 (2018-02-06)

scholarly journals Brain–Heart Axis and Biomarkers of Cardiac Damage and Dysfunction after Stroke: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 21 (7) ◽  
pp. 2347
Author(s):  
Chengyang Xu ◽  
Ang Zheng ◽  
Tianyi He ◽  
Zhipeng Cao
Keyword(s):  
Systematic Review ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Cardiac Biomarkers ◽  
Cochrane Library ◽  
Cardiac Complications ◽  
Brain Hemorrhage ◽  
Cardiac Damage ◽  
The Brain

Background: Cardiac complications after a stroke are the second leading cause of death worldwide, affecting the treatment and outcomes of stroke patients. Cardiac biomarkers such as cardiac troponin (cTn), brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) have been frequently reported in patients undergoing a stroke. The aim of the present study is to meta-analyze the relationship between changes in such cardiac biomarkers and stroke and to present a systematic review of the previous literature, so as to explore the brain–heart axis. Methods: We searched four online databases pertinent to the literature, including PubMed, Embase, the Cochrane Library, and the Web of Science. Then, we performed a meta-analysis to investigate changes in cTn, BNP, and NT-proBNP associated with different types of stroke. Results and Conclusions: A significant increase in cTnI concentration was found in patients exhibiting a brain hemorrhage. BNP increased in cases of brain infarction, while the NT-proBNP concentration was significantly elevated in patients suffering an acute ischemic stroke and brain hemorrhage, indicating cardiac damage and dysfunction after a stroke. Our analysis suggests that several potential mechanisms may be involved in the brain–heart axis. Finally, clinicians should pay careful attention to monitoring cardiac function in the treatment of cerebrovascular diseases in order to provide a timely and more accurate treatment.

scholarly journals Brain Natriuretic Peptide to Predict Successful Liberation from Mechanical Ventilation in Critically Ill Patients: a Systematic Review and Meta-Analysis.

2019 ◽  
Author(s):  
Jean Deschamps ◽  
Sarah K. Andersen ◽  
Jordan Webber ◽  
Robin Featherstone ◽  
Meghan Sebastianski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Brain Natriuretic Peptide ◽  
Critically Ill ◽  
Natriuretic Peptide ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Spontaneous Breathing Trial ◽  
Clinical Criteria ◽  
Clinical Indices

Abstract Background Predicting successful liberation from mechanical ventilation (MV) in critically ill patients is challenging. Brain natriuretic peptide (BNP) has been proposed to help guide decision-making for readiness to liberate from MV following a spontaneous breathing trial (SBT).Methods We performed a systematic review and meta-analysis of randomized and prospective observational studies that measured BNP levels at the time of SBT in patients receiving MV. The primary endpoint was successful liberation from MV (absence of re-intubation or non-invasive ventilation at 48h). Statistical analyses include bi-variate and Moses-Littenberg models, and DerSimonian-Laird pooling of areas under ROC curve (AUROC).Results A total of 731 articles were screened. After pre-specified inclusion criteria, 18 adult and 2 pediatric studies were included. The measure of the relative variation of BNP during SBT (ΔBNP%) after exclusion of SBT failure by clinical criteria in adults yielded a sensitivity and specificity of 0.889 [0.831-0.929] and 0.828 [0.730-0.896] respectively, with a pooled AUROC of 0.92 [0.88-0.97] for successful liberation from MV. The pooled AUROC for any method of analysis for absolute variation of BNP (ΔBNP), pre-SBT BNP and post-SBT BNP were 0.89 [0.83-0.95], 0.77 [0.63-0.91], and 0.85 [0.80-0.90], respectively.Conclusion The ΔBNP during a SBT is an accurate incremental tool after SBT success by clinical indices to predict successful liberation from MV in adults. There is insufficient data to support its use as an alternate test to clinical indices of SBT or the use of ΔBNP, BNP-pre and BNP-post as an alternate or incremental test, or in pediatric patients.

scholarly journals Diagnostic accuracy of point-of-care natriuretic peptide testing for chronic heart failure in ambulatory care: systematic review and meta-analysis

BMJ ◽  
2018 ◽  
pp. k1450 ◽  
Author(s):  
Kathryn S Taylor ◽  
Jan Y Verbakel ◽  
Benjamin G Feakins ◽  
Christopher P Price ◽  
Rafael Perera ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Chronic Heart Failure ◽  
Diagnostic Accuracy ◽  
Ambulatory Care ◽  
Natriuretic Peptide ◽  
Point Of Care ◽  
Meta Analysis
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