B-type natriuretic peptide prohormone in serum/plasma
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Introduction
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]
More general terms
Additional terms
References
- ↑ 1.0 1.1 1.2 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: https://www.ncbi.nlm.nih.gov/pubmed/25740799
- ↑ NT-Probnp Natriuretic Peptide Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0050083.jsp
- ↑ 3.0 3.1 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
- ↑ 4.0 4.1 4.2 4.3 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: https://www.ncbi.nlm.nih.gov/pubmed/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: https://www.ncbi.nlm.nih.gov/pubmed/29544602 https://www.sciencedirect.com/science/article/pii/S0735109718303437 - ↑ 5.0 5.1 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: https://www.ncbi.nlm.nih.gov/pubmed/29768145 https://www.nejm.org/doi/full/10.1056/NEJMcpc1800339
- ↑ 6.0 6.1 Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
- ↑ 7.0 7.1 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: https://www.ncbi.nlm.nih.gov/pubmed/27889914
- ↑ 8.0 8.1 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: https://www.ncbi.nlm.nih.gov/pubmed/31869834
- ↑ 9.0 9.1 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: https://www.ncbi.nlm.nih.gov/pubmed/32065760