The Use of NT-proBNP and BNP as Biomarkers of Acute Heart Failure

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Age-stratified Rule-in Cut-points • International Collaborative of NT-proBNP (ICON) Study data (acute setting): To Diagnose Acute Heart Failure Age strata All 75 years 1800 pg/ml 85% 73% 92% 55% 83% *Very superior to single cut-point strategy in multivariable bootstrapping models Source: Januzzi et al, Eur Heart J (2006) 27: 839-845. 20
NT-proBNP vs BNP for Acute Heart Failure General Summary • Individuals with heart failure typically have approximately 8-10X higher levels of NT-proBNP versus BNP. • Close to half of this difference is due to the difference in molecular weight of the two molecules (NT-proBNP is about 2.5X larger than BNP). • The rest is likely due to the fact that NT-proBNP has higher in vivo stability. • As an aid in the diagnosis of acute heart failure, a single NT-proBNP cut-point of 900 pg/mL offers performance essentially equivalent to a BNP cut-point of 100 pg/mL. • The ICON triple “rule-in” NT-proBNP cutpoints for acute heart failure (age-specific cutpoints of 450, 900, and 1800 pg/mL) are designed to account for the impacts of age and renal function • Both BNP and NT-proBNP increase with increasing age and decreasing renal function. • The ICON triple NT-proBNP cutpoints are designed to provide similar information, but with better performance, relative to the BNP cut-point of 100 pg/mL. • Relative to BNP, NT-proBNP also offers the benefits of platform harmonization and enhanced analyte stability, both in vitro and in vivo Source: Januzzi et al. Am. J. Cardiol 2008; 101: 29A-38A. 21
Page 1 and 2: The Use of NT-proBNP and BNP as Bio
Page 3 and 4: B-type Natriuretic Peptides Pre-Pro
Page 5 and 6: “Breathing Not Properly” Multin
Page 7 and 8: ValHeft Study: 2006 LVEF: left vent
Page 9 and 10: NT-proBNP Levels by Diagnosis in Pa
Page 11 and 12: VITROS ® NT-proBNP - Method Compar
Page 13 and 14: NT-proBNP in the Acute Setting 13
Page 15 and 16: NT-proBNP Levels by Diagnosis in Pa
Page 17 and 18: NT-proBNP Levels Predict Survival i
Page 19: Age-independent Rule-out Cut-point
Page 23 and 24: VITROS ® NT-proBNP - Intended Use
Page 25 and 26: NT-proBNP-Tailored CHF Therapy The
Page 27 and 28: Study Endpoints •1 endpoint •To
Page 29 and 30: Primary Endpoint 100 events P =.009
Page 31 and 32: Events as a function of NT-proBNP P
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The Use of NT-proBNP and BNP as Biomarkers of Acute Heart Failure

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