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CAMHS won't see you now

GPC acts over lithium quality confusion

A test that is becoming central to heart failure diagnosis could be falsely giving black patients the all-clear, an analysis of the landmark ASCOT trial reveals.

Researchers warned the B-natriuretic peptide test should be used with caution in black patients after finding their baseline levels of BNP were little over half as high as in white patients (see graph).

The ASCOT sub-study, which examined 562 patients from north-west London, found levels of BNP in

south Asians were intermediate between white and black patients, meaning they could also be underdiagnosed.

'The data suggests we should use levels from white subjects with caution in other ethnic groups,' said study leader Dr Jamil Mayet, honorary senior lecturer at the International Centre for Circulatory Health, Imperial College London. 'It may mean we

underestimate the risk in black or south Asian patients.'

Dr Ahmed Fuat, a GP in Darlington with a special interest in cardiology, said the BNP test was useful but problems with the cut-off value for heart failure meant it was 'not yet ready for widespread use in the NHS'.

The study, to be presented at the conference, found ethnicity remained highly significant even after correcting for other factors influencing BNP.

NICE recommends use of the BNP test when available alongside 12-lead ECG to

exclude heart failure.

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