C10 - Bionote Point-Of-Care Quantitative NT-Probnp Assay for Differentiating Stages of Preclinical Disease in Dogs and Cats

Abstract: Background - Quantitative N-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in combination with examination findings to stage preclinical cardiac disease in dogs and cats. Quantitative point-of-care (POC) NT-proBNP assays have not be evaluated for this purpose. Objectives - Assess reliability of Bionote POC quantitative NT-proBNP to differentiate between ACVIM stages B1 and B2 in myxomatous mitral valve disease dogs and hypertrophic cardiomyopathy cats. The ACVIM consensus statement was used to differentiate stages, and B2 cats required a left atrial diameter > 17 mm. Animals - A total of 96 dogs and 53 cats with stage B1 (51 dogs, 31 cats) or B2 (45 dogs, 22 cats) cardiac disease. Methods - Animals with echocardiographic evidence of cardiac disease and no comorbidities were prospectively enrolled. Bionote POC quantitative NT-proBNP was assess for all animals. Results - Stage B2 animals had higher (P=0.003) median NT-proBNP concentrations (cat, 886pmol/L; dog, 1206pmol/L) compared with B1 (cat, 199pmol/L; dog, 539pmol/L). Receiving operating characteristics (ROC) analysis indicated excellent discriminatory ability in dogs (AUC = 0.96, P< 0.0001) and good in cats (AUC = 0.83, P< 0.0001). Based on Youden index, a cutoff in dogs of >888pmol/L achieved a sensitivity of 87% and specificity of 94%, while a cutoff of >1004pmol/L achieved a specificity of 100%. A cutoff in cats of >342pmol/L achieved a sensitivity of 86% and specificity of 74%, while a cutoff >1332pmol/L achieved a specificity of 100%. Conclusions and clinical importance - POC quantitative NT-proBNP is useful for disease staging preclinical cardiac disease in dogs and cats.