PT  - JOURNAL ARTICLE
AU  - Q Zhou
AU  - Z J Ye
AU  - Y Su
AU  - J C Zhang
AU  - H Z Shi
TI  - Diagnostic value of N-terminal pro-brain natriuretic peptide for pleural effusion due to heart failure: a meta-analysis
AID  - 10.1136/hrt.2009.188474
DP  - 2010 Aug 01
TA  - Heart
PG  - 1207--1211
VI  - 96
IP  - 15
4099  - http://heart.bmj.com/content/96/15/1207.short
4100  - http://heart.bmj.com/content/96/15/1207.full
SO  - Heart2010 Aug 01; 96
AB  - Background N-terminal pro-brain natriuretic peptide (NT-proBNP) is a biomarker useful in diagnosis of pleural effusion due to heart failure. Thus far, its overall diagnostic accuracy has not been systematically reviewed. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of the measurement of pleural NT-proBNP for identifying pleural effusion due to heart failure.Methods After a systematic review of English-language studies, sensitivity, specificity, and other measures of accuracy of NT-proBNP concentrations in pleural fluid in the diagnosis of pleural effusion resulting from heart failure were pooled using fixed-effects models. Summary receiver operating characteristic curves were used to summarise overall test performance.Results Eight publications met the inclusion criteria. The summary estimates for pleural NT-proBNP in the diagnosis of pleural effusion attributable to heart failure were: sensitivity 0.95 (95% CI 0.92 to 0.97), specificity 0.94 (0.92 to 0.96), positive likelihood ratio 14.12 (10.23 to 19.51), negative likelihood ratio 0.06 (0.04 to 0.09) and diagnostic OR 213.87 (122.50 to 373.40).Conclusions NT-proBNP levels in pleural fluid showed a high diagnostic accuracy and may help accurately differentiate cardiac from non-cardiac conditions in patients presenting with pleural effusion.