The Use of NT-proBNP and BNP as Biomarkers of Acute Heart Failure
The Use of NT-proBNP and BNP as Biomarkers of Acute Heart Failure
The Use of NT-proBNP and BNP as Biomarkers of Acute Heart Failure
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<strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> vs <strong>BNP</strong> for <strong>Acute</strong> <strong>Heart</strong> <strong>Failure</strong><br />
General Summary<br />
• Individuals with heart failure typically have approximately 8-10X higher<br />
levels <strong>of</strong> <strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> versus <strong>BNP</strong>.<br />
• Close to half <strong>of</strong> this difference is due to the difference in molecular weight <strong>of</strong> the two molecules<br />
(<strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> is about 2.5X larger than <strong>BNP</strong>).<br />
• <strong>The</strong> rest is likely due to the fact that <strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> h<strong>as</strong> higher in vivo stability.<br />
• As an aid in the diagnosis <strong>of</strong> acute heart failure, a single <strong>NT</strong>-<strong>pro<strong>BNP</strong></strong><br />
cut-point <strong>of</strong> 900 pg/mL <strong>of</strong>fers performance essentially equivalent to a<br />
<strong>BNP</strong> cut-point <strong>of</strong> 100 pg/mL.<br />
• <strong>The</strong> ICON triple “rule-in” <strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> cutpoints for acute heart failure<br />
(age-specific cutpoints <strong>of</strong> 450, 900, <strong>and</strong> 1800 pg/mL) are designed to<br />
account for the impacts <strong>of</strong> age <strong>and</strong> renal function<br />
• Both <strong>BNP</strong> <strong>and</strong> <strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> incre<strong>as</strong>e with incre<strong>as</strong>ing age <strong>and</strong> decre<strong>as</strong>ing renal function.<br />
• <strong>The</strong> ICON triple <strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> cutpoints are designed to provide similar information, but with better<br />
performance, relative to the <strong>BNP</strong> cut-point <strong>of</strong> 100 pg/mL.<br />
• Relative to <strong>BNP</strong>, <strong>NT</strong>-<strong>pro<strong>BNP</strong></strong> also <strong>of</strong>fers the benefits <strong>of</strong> platform<br />
harmonization <strong>and</strong> enhanced analyte stability, both in vitro <strong>and</strong> in vivo<br />
Source:<br />
Januzzi et al. Am. J. Cardiol 2008; 101: 29A-38A.<br />
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