N-terminal Pro B-type natriuretic peptide

Background:

Please note: from 01.10.18, NT-ProBNP analysis will replace analysis of BNP in evaluation of patients with heart failure. The current BNP assay will no longer be available. A letter has been distributed to clinical teams explaining the change.

The new NT-proBNP assay can be performed on a serum sample (yellow/red top) and does not require an additional blood sample to be collected.

NT-proBNP is used as a rule-out test for heart failure

Patients with suspected heart failure and a NT-proBNP level above 2000 ng/L should be urgently referred to have transthoracic Doppler 2D echocardiography and specialist assessment within 2 weeks.

Refer patients with suspected heart failure and a NT-proBNP level between 400 and 2000 ng/L to have transthoracic Doppler 2D echocardiography and specialist assessment within 6 weeks.

Reduced levels of serum natriuretic peptides can be caused by obesity, or treatment with diuretics, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, angiotensin II receptor antagonists (ARBs) or aldosterone antagonists

Increased levels of serum natriuretic peptides can have causes other than heart failure (for example, left ventricular hypertrophy, ischaemia, tachycardia, right ventricular overload, hypoxaemia [including pulmonary embolism], renal dysfunction [GFR 60 ml/minute], sepsis, chronic obstructive pulmonary disease [COPD], diabetes, age 70 years and cirrhosis of the liver)

Information from:  Chronic heart failure in adults: management. NICE Clinical guideline [NG106] Published date: September 2018

Other Comments:

For more information, please see the following: NT-proBNP - Lab Tests Online