NT-proBNP
Code:13004|CPT:83880|LOINC:33762-6
| Includes | NT-proBNP |
|---|
Analysis details
Methodology
- Electrochemiluminescence immunoassay (ECLIA)
- Immunochromatography
Expected Turnaround Time
1 day
Special Instructions
- Maintain a 12-hour fast before the specimen is collected.
- Avoid vigorous physical activity and minimize emotional stress for at least 30 minutes prior to collection.
- Do not smoke during the 30 minutes preceding collection.
- Review biotin supplementation; discontinue high-dose biotin for a minimum of 72 hours before specimen collection.
How to use
The NT-proBNP test (N-terminal pro–B-type natriuretic peptide; proBNP) is used to support the diagnosis of suspected heart failure and to help differentiate cardiac from pulmonary etiologies of dyspnea. It assists in grading the severity of heart failure and in monitoring response to therapy over time. NT-proBNP also supports risk stratification in acute coronary syndrome and in chronic heart failure. In patients at risk for heart failure with stable coronary artery disease, results may aid in estimating the likelihood of cardiovascular events and mortality.
Limitations
Ventricular myocytes synthesize proBNP, which is cleaved into the biologically active B-type natriuretic peptide (BNP) and the inactive NT-proBNP fragment. Increased ventricular wall tension due to pressure or volume overload stimulates release of both peptides, which in turn promote natriuresis and diuresis. NT-proBNP concentrations require interpretation alongside clinical findings and other cardiovascular risk factors. Values can be higher in the presence of concomitant cardiac, pulmonary, or renal disease, and diagnostic performance for heart failure is diminished in atrial fibrillation and in sepsis; clinical correlation is essential.
| Unit | pg/mL | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference interval |
| ||||||||||||
| Indications | Assessment of patients with possible heart failure, Risk stratification in the context of acute coronary syndromes, Monitoring the effectiveness of therapy for heart failure |
Possible Causes of Abnormal Results
Increased levels
- advanced age
- atrial fibrillation
- cardiac disease
- chronic kidney disease
- female sex
- pulmonary disease
- sepsis
Decreased levels
- biotin (high-dose)
Specimen Requirements
| Specimen | Serum |
|---|---|
| Container | Gold/Tiger Top (SST, Gel Separator) |
| Volume | 1 mL (min 0.7 mL) |
| Storage Instructions | Room temperature, Refrigerated, Frozen |
References
Elecsys proBNP II [package insert]. Indianapolis, IN: Roche Diagnostics; 2018, V1.0 English.
McCullough PA, Kluger AY. Interpreting the Wide Range of NT-proBNP Concentrations in Clinical Decision Making. J Am Coll Cardiol. 2018 Mar 20;71(11):1201-1203. PubMed 29544602
McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. PubMed 34447992