Meta-analysis: Diagnostic Value of N-Terminal Pro-brain Natriuretic Peptide for Kawasaki Disease

Background: Some studies have estimated the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) for Kawasaki Disease (KD), but the results are not always consistent. The aim of this study was to ascertain the diagnostic value of NT-proBNP for KD. Methods: EMBSAE and PubMed were searched up to June 30, 2015, to identify eligible studies that evaluated the diagnostic value of NT-proBNP for KD. The quality of the eligible studies was evaluated using the revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tools. The overall diagnostic value of NT-proBNP for KD was pooled in a bivariate model. Results: Finally, 7 studies were included for systematic review and meta-analysis. The overall diagnostic sensitivity and specificity were 0.84 (95% CI: 0.78 - 0.89) and 0.79 (95% CI: 0.74 - 0.84), respectively. The area under the summary receiver operating characteristic (sROC) curve (AUC) was 0.87 (95% CI: 0.84 - 0.90). The overall sensitivity and specificity across five studies adopted the threshold of approximately 200 ng/L were 0.85 (95% CI: 0.78 - 0.90) and 0.76 (95% CI: 0.69 - 0.82), respectively. The major design weaknesses of the eligible studies were two-gate design and threshold not pre-specified. Conclusions: We concluded that available studies suggest that NT-proBNP is a useful biomarker for KD. In addition, further well-designed studies are needed to rigorously evaluate the value of NT-proBNP in KD diagnosis.