NT-proBNP

 

Alternative names, keywords

N-terminal pro B-type natriuretic peptide, BNP

Samples required

Clotted blood (gold cap, 5 mL tube).

Patient does not need to fast.

Test indications

 

Factors affecting test performance/ results

Samples should not be taken from patients receiving therapy with high biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin administration.

In rare cases, interference due to extremely high titres of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.

In extremely rare cases (global incidence: < 1 in 10 million), patients may show discrepant results when tested with the assay kit (values below lower detection limit) due to a NT-proBNP genetic variant.

Results should always be assessed in conjunction with the patient’s medical history, clinical examination and other findings.

Reference range

Reference ranges (see below for clinical cut-offs):

Age (years)

Male

Female

18 - 44

< 86 pg/mL

< 130 pg/mL

45 - 54

< 121 pg/mL

< 249 pg/mL

55 - 64

< 210 pg/mL

< 287 pg/mL

65 - 74

< 376 pg/mL

< 301 pg/mL

≥ 75

< 486 pg/mL

< 738 pg/mL

Source: Roche Cobas® N-terminal pro B-type natriuretic peptide kit insert 02-2015, V9.0

Non-HF causes of high NTproBNP: LVH, ischaemia, tachycardia, RV overload, hypoxaemia (including pulmonary embolism), renal dysfunction (GFR < 60 ml/min), sepsis, COPD, diabetes, age > 70 years, cirrhosis of the liver.

Obesity or treatment with diuretics, ACE inhibitors, beta-blockers, angiotensin II receptor antagonists (ARBs) and aldosterone antagonists can reduce levels of serum natriuretic peptides.

 

From NICE guideline NG106 Chronic heart failure in adults: diagnosis and management (published September 2012), for patients with suspected heart failure:

NTproBNP:

 

< 400 pg/mL

Heart failure unlikely in untreated patient.

400 - 2000 pg/mL

Refer for specialist assessment within 6 weeks.

above 2000 pg/mL

Refer for specialist assessment within 2 weeks.

 

In treated patients lower referral cut offs apply, as endorsed by the Enhancing Quality Programme BNP Toolkit, which has been adopted by NICE.

< 70 yrs

greater than or equal to 100 pg/mL (males)

greater than or equal to 150 pg/mL (female)

>70 yrs

greater than or equal to 300 pg/mL (male and female)

 

Turnaround time

3 days

Enquiries

Biochemistry (Automation)