Peer-Reviewed Publication
Eur Heart J Acute Cardiovasc Care2025;14(8):474-488.August 7, 2025Journal Article
Machine learning to optimize use of natriuretic peptides in the diagnosis of acute heart failure.
Dimitrios Doudesis1,2, Kuan Ken Lee1, Mohamed Anwar1, Adam J Singer3, Judd E Hollander4, Camille Chenevier-Gobeaux5, Yann-Erick Claessens6, Desiree Wussler7,8, Dominic Weil7, Nikola Kozhuharov7,9, Ivo Strebel7, Zaid Sabti7, Christopher deFilippi10, Stephen Seliger11, Evandro Tinoco Mesquita12, Jan C Wiemer13, Martin Möckel14, Joel Coste15, Patrick Jourdain16, Komukai Kimiaki17, Michihiro Yoshimura17, Irwani Ibrahim18, Shirley Beng Suat Ooi18, Win Sen Kuan18, Alfons Gegenhuber19, Thomas Mueller20, Olivier Hanon21, Jean-Sébastien Vidal21, Peter Cameron22, Louisa Lam22,23, Ben Freedman24, Tommy Chung25, Sean P Collins26, Christopher J Lindsell27, David E Newby1, Alan G Japp1, Anoop S V Shah1,28, Humberto Villacorta12, A Mark Richards29,30, John J V McMurray31, Christian Mueller7, James L Januzzi32,33, Nicholas L Mills1,2,
1British Heart Foundation (BHF) Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SA, UK.
2Usher Institute, University of Edinburgh, Edinburgh EH16 4UX, UK.
3Department of Emergency Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
4Department of Emergency Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, USA.
5Department of Biochemistry, Cochin Hospital, Assistance Publique-Hopitaux de Paris, Paris, France.
6Department of Emergency Medicine, Princess Grace Hospital Center, Monaco, Principalty of Monaco.
7Department of Cardiology, Cardiovascular Research Institute of Basel, University Hospital Basel, Basel, Switzerland.
8Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
9Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK.
10Division of Cardiology, University of Maryland School of Medicine, Baltimore, USA.
11Division of Nephrology, University of Maryland School of Medicine, Baltimore, USA.
12Cardiology Division, Fluminense Federal University, Niteroi, Rio de Janeiro State, Brazil.
13B·R·A·H·M·S, Thermo Fisher Scientific, Hennigsdorf, Germany.
14Department of Emergency and Acute Medicine with Chest Pain Units, Charité-Universitätsmedizin Berlin, Campus Mitte and Virchow, Berlin, Germany.
15Biostatistics and Epidemiology Unit, Cochin Hospital, Paris, France.
16Cardiology Department, AP-HP, Paris-Saclay University, Paris, France.
17Division of Cardiology, The Jikei University Kashiwa Hospital, Kashiwa, Japan.
18Emergency Medicine Department, National University Hospital, Singapore, Singapore.
19Department of Internal Medicine, Krankenhaus Bad Ischl, Bad Ischl, Austria.
20Department of Laboratory Medicine, Hospital Voecklabruck, Voecklabruck, Austria.
21Department of Geriatrics, Broca Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
22Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
23Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
24Heart Research Institute, University of Sydney, Sydney, Australia.
25Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia.
26Department of Emergency Medicine, Vanderbilt University Medical Center, and Veterans Affairs Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, TN, USA.
27Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
28Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
29Christchurch Heart Institute, University of Otago, Christchurch, New Zealand.
30Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore.
31BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
32Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Bain Institute for Clinical Research, Boston, MA, USA.
33Heart Failure and Biomarker Trials, Baim Institute for Clinical Research, Boston, MA, USA.
Abstract
AIMS: B-type natriuretic peptide (BNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) testing are guideline-recommended to aid in the diagnosis of acute heart failure. Nevertheless, the diagnostic performance of these biomarkers is uncertain.
METHODS AND RESULTS: We performed a systematic review and individual patient-level data meta-analysis to evaluate the diagnostic performance of…
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