Heart failure & cardiomyopathies
Age-Adjusted Natriuretic Peptide Thresholds for a Diagnosis of Heart Failure in the Community: Diagnostic Accuracy Study
Authors' conclusion
At ESC HFA age-adjusted thresholds, the number of referrals required for HF diagnostic assessment are substantially reduced, but with some (likely lower risk) cases initially being undetected.
Study context
- Population
- Patients with NT-proBNP tests, linked primary and secondary care data, England, 2004–201814,585 (9.4%) diagnosed with heart failure (HF)
- Participants
- 155,347 patients
- Comparison
- European Society of Cardiology (ESC) Heart Failure Association (HFA) age-adjusted NT-proBNP thresholds vs ESC single threshold ≥125 pg/mL
- Outcome
- NT-proBNP test performance (sensitivity, specificity) for HF diagnosis
Methodological detailslinked primary and secondary care data
- Linked primary and secondary care data
Performance
As reported in the abstract
| Strategy | Sensitivity | Sensitivity (<50, 50-74, ≥75 years) | Specificity | Specificity (<50, 50-74, ≥75 years) |
|---|---|---|---|---|
| Single threshold | 94.6% (95% CI 94.2-95.0)Sensitivity on a scale from 0 to 100 percent | — not stated in the abstract | 50.0% (49.7-50.3)Specificity on a scale from 0 to 100 percent | — not stated in the abstract |
| Age-adjusted thresholds | — not stated in the abstract | 83.5%, 88.5%, 84.4% | — not stated in the abstract | 77.6%, 67.8%, 63.5% |
| High-risk threshold | 38.9% (38.1-39.7)Sensitivity on a scale from 0 to 100 percent | — not stated in the abstract | 96.1% (96.0-96.2)Specificity on a scale from 0 to 100 percent | — not stated in the abstract |
Sensitivity
Single threshold94.6% (95% CI 94.2-95.0)
Age-adjusted thresholds— not stated in the abstract
High-risk threshold38.9% (38.1-39.7)
Sensitivity on a scale from 0 to 100 percentSensitivity (<50, 50-74, ≥75 years)
Single threshold— not stated in the abstract
Age-adjusted thresholds83.5%, 88.5%, 84.4%
High-risk threshold— not stated in the abstract
Specificity
Single threshold50.0% (49.7-50.3)
Age-adjusted thresholds— not stated in the abstract
High-risk threshold96.1% (96.0-96.2)
Specificity on a scale from 0 to 100 percentSpecificity (<50, 50-74, ≥75 years)
Single threshold— not stated in the abstract
Age-adjusted thresholds77.6%, 67.8%, 63.5%
High-risk threshold— not stated in the abstract
— not stated in the abstract
Further findings
Test performance by body mass index (BMI)
- High BMI associated with lower sensitivity at each age-adjusted threshold, improved with adjustment by obesity category
Test performance by sex
- Test performance similar in women and men
Original publication
Age-Adjusted Natriuretic Peptide Thresholds for a Diagnosis of Heart Failure in the Community: Diagnostic Accuracy Study. ESC Heart Fail. Published 27 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →