ReviewCureus2026
Clinical Use of N-terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) in Diagnosing Acute Heart Failure in Emergency Settings: A Systematic Review.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute heart failure (AHF) is a common emergency department presentation where rapid and accurate diagnosis is challenging. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a widely used biomarker for AHF, but uncertainty remains regarding optimal cut-offs and performance across patient subgroups. This systematic review evaluates the diagnostic utility of NT-proBNP for AHF in emergency settings. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed, Embase, Scopus, and Web of Science (January 2021-April 2026). Eligible studies enrolled adults with suspected AHF in emergency settings, used NT-proBNP as the index test, and reported diagnostic accuracy outcomes. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A narrative synthesis was performed. Eight studies were included. Across prospective emergency department studies, an NT-proBNP threshold of <300 pg/mL demonstrated strong rule-out performance, with reported sensitivities ranging from 96% to approximately 99% and negative predictive values ranging from 94.8% to 95%, depending on the study population and reference standard. Age-adjusted cut-offs (450/900/1800 pg/mL) produced rule-in specificities of 61-87%. Diagnostic accuracy was significantly reduced in patients with atrial fibrillation (AF), congenital heart disease (CHD), and heart failure with preserved ejection fraction (HFpEF). Five studies had low risk of bias, while three had high risk. NT-proBNP is a highly effective rule-out test for AHF using a <300 pg/mL cut-off. Age-adjusted cut-offs improve rule-in specificity. Performance is attenuated in key subgroups, requiring modified interpretation. Despite some methodological limitations, current evidence strongly supports routine NT-proBNP use in emergency department patients with suspected AHF.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.