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B-type natriuretic peptide prohormone in serum/plasma

see B-type natriuretic peptide in serum/plasma Indications: - evaluation of acute heart failure [4] * both BNP & NT-proBNP are widely used to aid diagnosis, assess effect of therapy, & predict prognosis in heart failure with reduced ejection fraction; the two have similar predictive values [9] Reference interval: - rule out acute heart failure < 300 ng/L [1,4} - rule in acute heart failure: [4] - > 450 ng/L age < 50 years, specificity 94% - > 900 ng/L age 50-75 years, specificity 84% - > 1800 ng/L age > 75 years, specificity 75% Clinical significance: - acute heart failure unlikely with serum pro-BNP is < 300 ng/L [1,4] - sensitivity is 99% - specificity is 43% - positive predictive value (PPV) is 64% - negative predictive value (NPV) is 98% - diagnostic accuracy similar to serum BNP [1] - use of no benefit in preventing hospital readmission [3] - predicts mortality in older adults hospitalized with heart failure [6,7] - preoperative NT-ProBNP predicts postoperative cardiovascular events [8] - may be elevated with digoxin toxicity [5]

Related

basic (brain) natriuretic peptide (BNP, B-type) prohormone

General

B-type natriuretic peptide prohormone in serum/plasma/blood

References

  1. Roberts E et al. The diagnostic accuracy of the natriuretic peptides in heart failure: Systematic review and diagnostic meta-analysis in the acute care setting. BMJ 2015 Mar 4; 350:h910 PMID: 25740799
  2. NT-Probnp Natriuretic Peptide Laboratory Test Directory ARUP: 50083
  3. Lou N NT-proBNP-Targeted Tx Not Better in Post-Acute HF, PRIMA II trial shows no readmission, mortality benefit overall. MEDPAGE Today. Sept 22, 2016 cites Heart Failure Society of America Annual Meeting Sept 2016 http://www.medpagetoday.com/Cardiology/CHF/60413
  4. Januzzi JL Jr., Chen-Tournoux AA, Christenson RH et al. N-terminal pro-B-type natriuretic peptide in the emergency department: The ICON-RELOADED study. J Am Coll Cardiol 2018 Mar 20; 71:1191 PMID: 29544601 Free Article https://www.sciencedirect.com/science/article/pii/S0735109718301669 - McCullough PA, Kluger AY. Interpreting the wide range of NT-proBNP concentrations in clinical decision making. J Am Coll Cardiol 2018 Mar 20; 71:1201 PMID: 29544602 https://www.sciencedirect.com/science/article/pii/S0735109718303437
  5. Mattison MLP, Muse VV, Simmons LH Case 15-2018: An 83-Year-Old Woman with Nausea, Vomiting, and Confusion. N Engl J Med 2018; 378:1931-1938. May 17, 2018. PMID: 29768145 https://www.nejm.org/doi/full/10.1056/NEJMcpc1800339
  6. Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
  7. Passantino A, Guida P, Lagioia R et al Predictors of Long-Term Mortality in Older Patients Hospitalized for Acutely Decompensated Heart Failure: Clinical Relevance of Natriuretic Peptides. J Am Geriatr Soc. 2017 Apr;65(4):822-826. PMID: 27889914
  8. Duceppe E, Patel A, Chan MTV et al. Preoperative N-terminal pro-B-type natriuretic peptide and cardiovascular events after noncardiac surgery: A cohort study. Ann Intern Med 2019 Dec 24 PMID: 31869834
  9. Rorth R et al. Comparison of BNP and NT-proBNP in patients with heart failure and reduced ejection fraction. Circ Heart Fail 2020 Feb; 13:e006541 PMID: 32065760