Triage patients at need

of urgent specialist

assessment³

Rule-out heart failure and

reduce pressure on

echocardiography services¹

Costs less than £28 per

patient (compared to £337

for an echocardiogram)⁴

Early and accurate diagnosis of

heart failure has the potential to

reduce rates of misdiagnosis and

GP appointments²

Enable faster access to

effective treatments and

improve patient outcomes⁶ 

Reduce emergency

hospital admissions⁶

What is NT-proBNP?

NT-proBNP is a form of natriuretic peptide (NP) released by cardiac tissue in response to volume and/or pressure overload that causes the walls of the heart to stretch. NPs promote natriuresis and diuresis and act as vasodilators, to help regulate this pressure.⁸

Why test for NT-proBNP?

NT-proBNP has a very high diagnostic sensitivity for heart failure and testing in patients with symptoms delivers a fast route to ruling out heart failure as a diagnosis. High levels of NT-proBNP are associated with a poor prognosis. Patients with values >2,000 ng/l are at greater risk of death⁹. High levels therefore indicate the need for urgent referral³.

Understand the results

The following information has been sourced from the NICE guidelines. High levels of natriuretic peptides are associated with a poor prognosis and indicate the need for urgent referral and management.

• NT-proBNP >2000 pg/mL should be referred for transthoracic Doppler 2D echocardiography and specialist assessment within 2 weeks because such high levels carry a poor prognosis.
•  NT-proBNP 400-2000 pg/mL should be referred for transthoracic Doppler 2D echocardiography and specialist assessment within 6 weeks.
• NT-proBNP of <400 pg/mL in an untreated patient makes a diagnosis of heart failure highly unlikely.³

Comorbidities

People with heart failure are often living with several long term conditions; a large study using UK data found that 79% of people with heart failure had three or more comorbidities.¹⁰ Patients may assume their symptoms are related to these other conditions or to side effects of medications they are taking. In a survey of 110 primary care clinicians, 80% reported that multiple comorbidities were the biggest challenge in recognising potential heart failure in patients.¹¹

Respiratory comorbidities, renal dysfunction, anaemia, arthritis, cognitive dysfunction and depression, among others, often lead to heart failure being overlooked in primary care.¹²