Abstract 17516: Screening for Heart Disease in Rural China with Fingerstick BNP and Echo: Results of the ALERT (Asia Pacific Link to Evaluation and Referral for Treatment) Trial
China is faced with a large percentage of the population with limited health care access, especially in rural areas. We proposed that a finger stick BNP test might identify children with compromised congenital heart disease as well as adults with cardiac dysfunction. Along with Peking's Peoples Hospital and the Chinese Red Cross, we traveled to three rural hospitals in Ruijin Jiangxi province, where significant congenital heart disease (CHD) exists. A notice was sent to all three communities that anyone with heart problems, symptoms of heart disease, or who would like to be screened for heart disease could attend. After consent was signed, a questionnaire (history and symptoms) was filled out, followed by blood pressure, ECG, echocardiography, and finger stick BNP (Alere, inc) test. Those with significant heart disease were referred on the spot to a cardiologist and/ or a cardiac surgeon. In this first session, we screened 38 children (at least 5 years old) and 142 adults (37% male, mean age 60). In children, while no absolute level of BNP was related to the presence or absence of CHD, finger stick BNP levels great than 35 pg/ml were associated with significant cardiac compromise. The area under the ROC curve was 0.75. In adults, BNP levels > 150 pg/ml identified those with significant systolic or diastolic dysfunction or valvular disease with only 4% false positives (area under ROC= 0.90). Thus, it appears that a simple finger stick BNP test can identify those children with significant congenital heart disease and adults with advanced heart disease who should move to the “front-lines” of health care management.
- © 2011 by American Heart Association, Inc.