Arq. Bras. Cardiol. 2022; 119(2): 212-222
Diagnostic Role of NT-proBNP in Patients with Cardiac Amyloidosis Involvement: A Meta-Analysis
This Original Article is referred by the Short Editorial "Utility of Biomarkers in Suspected Cardiac Amyloidosis: Opportunity for More Frequent and Early Diagnosis".
Abstract
Background
Amyloidosis is defined as a disorder characterized by the deposition of extracellular protein material of amyloid in tissues.
Objectives
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is used to predict the cardiac amyloidosis (CA), but its diagnostic effect on CA involvement remains unclear, especially in terms of specificity and sensitivity.
Methods
A search for literature was conducted in the Pubmed, Embase, and Cochrane library databases, and QUADAS 2 was used for quality assessment. Midas command in Stata 12.0 was used to analyze the subject indicators. Cochran’s Q and I2were to test for heterogeneity, and the significant heterogeneity was set at p < 0.05 and/or I2> 50%. Spearman correlation analysis was used to evaluate the threshold effect, and the publication bias was assessed using the asymmetry test. The statistical significance was set at p < 0.05.
Results
As results, 10 sets of data from 7 studies were included for analysis, showing high methodological quality and minimal confounding bias. The sensitivity and specificity of NT-proBNP in the diagnosis of cardiac involvement for patients with amyloidosis were 0.93 and 0.84, respectively. ROC curves also suggested a high diagnostic validity of NT-proBNP with an AUC of 0.95. A Fagan’s nomogram plot showed probabilities for NT-proBNP positive and negative in developing CA involvement were 90% and 8%, respectively. The Deek’s funnel plot suggested no significant publication bias across included studies, and the results were stable and reliable.
Conclusions
NT-proBNP plays the positive role in the early diagnosis of CA involvement with high sensitivity and specificity.
Keywords: Amyloidosis; Diagnosis; Network Meta-Analysis
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