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Konstantinides, S. et al. (2014). Eur Heart J 35, 3033-3080.
Ponikowski, P. et al. (2016). Eur J Heart Fail 18(8), 891-975.
Roffi , M. et al. (2015). Eur Heart J 37(3), 267-315.
Stengaard, C. et al. (2013). American J Cardiol 112(9), 1361-1366.
Achar, S.A. et al. (2005). Am Fam Physician 72(1), 119-126.
Bertsch, T. et al. (2010). Clin Lab. 56(1-2), 37-49. ; Jungbauer, C. et al. (2017). Cli Lab 63(4), 633-645.
Roche (2016). cobas h 232 POC system Operator’s Manual, Version 6.0.
DS-2023-JUL-001
What is NT-proBNP?
NT-proBNP has been used in HF for over 15 years, and is considered the gold standard for testing in HF disease management.13
NT-proBNP also has an emerging and impactful use in T2DM patients, who are at an increased risk of CVD complications.14-17
Natriuretic peptides, including NT-proBNP, are produced within cardiomyocytes in response to stress, and are released after clinical triggers.12
Use as an initial diagnostic test
In association with clinical evaluation,* NT-proBNP can support decision-making in HF diagnosis in acute and non-acute Settings.
Exclude HF and avoid unnecessary echocardiography6-8
Identify patients with high probability of having HF and need further investigation2
In primary care, identify patients who need referral to the specialist6-8
Interpretation of NT-proBNP results in patients presenting
in non-acute setting1-5
Roche NT-proBNP
<125pg/mL HF unlikely,
consider other diagnoses
Roche NT-proBNP
Roche NT-proBNP
>125pg/mL
HF likely,
perform
echocardiography to
confirm the diagnosis
of HF
Interpretation of NT-proBNP results in patients presenting
in non-acute setting9-13
Roche NT-proBNP
Roche NT-proBNP
<125pg/mL HF unlikely,
consider other diagnoses
Roche NT-proBNP
>125pg/mL
HF likely,
perform
echocardiography to
confirm the diagnosis
of HF
Use as out patient monitoring
NT-proBNP can be used to monitor disease progression or patient improvement in out-patient setting
Monitoring NT-proBNP levels helps to manage HF well over the long term, regardless of symptoms or medication being taken, in particular angiotensin receptor-neprilysininhibitors (ARNis)9.
Rutten et al. https://ipccs.org/2017/12/10/epccs-practical-guidance-on-heart-failurediagnosis-and-management-in-primary-care/ (Accessed May 24 2022).
Ponikowski P, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18(8):891-975. doi:10.1002/ejhf.592.
Taylor CJ, et al. Primary care REFerral for EchocaRdiogram (REFER) in heart failure: a diagnostic accuracy study. Br J Gen Pract. 2017;67(655):e94-e102. doi:10.3399/bjgp16X688393.
Taylor et al. (2017). Efficacy and Mechanism Evaluation, No. 4.3. National Institute for Health Research. ISSN 2050-4365.
Hildebrandt P, Collinson PO, Doughty RN, et al. Age-dependent values of N-terminal pro-B-type natriuretic peptide are superior to a single cut-point for ruling out suspected systolic dysfunction in primary care. Eur Heart J. 2010;31(15):1881-1889. oi:10.1093/eurheartj/ehq163.
Taylor, C.J. et al. (2017). Br J Gen Pract. 67(655), e94-e102.
Taylor, C.J. et al. (2017). Effi cacy and Mechanism Evaluation, No. 4.3. National Institute for Health. Research. ISSN 2050-4365. [Accessed September 2018].
British Heart Foundation and the All-Party Parliamentary Group on Heart Disease (2016). Focus on Heart Failure. Report accessible on https://www.bhf.org.uk/get-involved/campaigning/inquiry-intoliving-with-heart-failure [Accessed September 2018].
Januzzi, J.L. et al. (2016). Clin Chem 62(5), 663-665.
Masson, S. et al. (2008). J Am Coll Cardiol 52, 997-1000.
Weber M, Hamm C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart. 2006;92(6):843-849. doi:10.1136/hrt.2005.071233.
McKie PM, Burnett JC Jr. NT-proBNP: The Gold Standard Biomarker in Heart Failure. J Am Coll Cardiol. 2016;68(22):2437-2439. doi:10.1016/j.jacc.2016.10.001.
Huelsmann M, et al. NT-proBNP has a high negative predictive value to rule-out short-term cardiovascular events in patients with diabetes mellitus. Eur Heart J. 2008;29(18):2259-2264. doi:10.1093/eurheartj/ehn334.
Huelsmann M, et al. PONTIAC (NT-proBNP selected prevention of cardiac events in a population of diabetic patients without a history of cardiac disease): a prospective randomized controlled trial. J Am Coll Cardiol. 2013;62(15):1365-1372. doi:10.1016/j.jacc.2013.05.069.
Scirica BM, et al. Heart failure, saxagliptin, and diabetes mellitus: observations from the SAVOR-TIMI 53 randomized trial [published correction appears in Circulation. 2015 Oct 13;132(15):e198]. Circulation. 2014;130(18):1579-1588. doi:10.1161/ CIRCULATIONAHA.114.010389.
Einarson TR, et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17(1):83. Published 2018 Jun 8. doi:10.1186/s12933-018-0728-6.