Test Details
N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP)
Brain natriuretic peptide (BNP) is a neurohormone that affects body fluid homeostasis via diuresis and natriuresis. Elevated levels are seen in patients with congestive heart failure and a decreased ejection fraction.1 NT-proBNP is the precursor molecule for BNP.
Methodology
Immunoassay
Patient Preparation
None
Preferred Specimen
1.0 mL serum (0.5 mL minimum) collected in serum separator tube (SST/Tiger Top)
Alternate Specimen
1.0 mL EDTA plasma (0.5 mL minimum) collected in plasma separator tube (Pearl Top). Separate plasma as soon as possible after collection.
Transport Temperature
Refrigerated (ship on frozen cold packs)
Stability
Refrigerated: 6 days
References:
- Savarese G, Trimarco B, Dellegrottaglie S, et al. Natriuretic peptide-guided therapy in chronic heart failure: a meta-analysis of 2,686 patients in 12 randomized trials. PLoS One. 2013;8(3):e58287.
Lab Values
N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP)
Age: ≤75 yrs
- Optimal: <125 pg/mL
- Borderline: 125–450 pg/mL
- Increased Risk: >450 pg/mL
Age: >75 yrs
- Optimal: <450 pg/mL
- Borderline: 450 pg/mL
- Increased Risk: >450 pg/mL
Clinical Significance
N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP)
Elevated levels Identify subjects with left ventricular dysfunction.1
- Every incremental increase in values above normal is associated with an incremental increase in CV risk.
- Levels >450 pg/mL in subjects with stable CAD are associated with a 2- to 6-fold increased risk for cardiac morbidity and/or mortality.
- Normal levels exclude cardiac dysfunction.
References:
- Savarese G, Trimarco B, Dellegrottaglie S, et al. Natriuretic peptide-guided therapy in chronic heart failure: a meta-analysis of 2,686 patients in 12 randomized trials. PLoS One. 2013;8(3):e58287.
Treatment Options
N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP)
Identify etiology of elevated NT-proBNP with physical assessment and additional diagnostic tests, such as echocardiography, as indicated.
Treatment is based on cause of elevated NT-proBNP and may include medications that reduce heart strain.
