Use of NT‐proBNP in routine testing and comparison to BNP

Open Access
Publisher Website
Google Scholar
Abstract
Objectives: B‐type natriuretic peptide (BNP) is a strong diagnostic predictor of left‐ventricular (LV)‐dysfunction. Recently, the aminoterminal portion of pro‐BNP (NT‐proBNP) has been introduced, which could be even more sensitive because of its longer half‐life. The aim of this study was to evaluate the new marker NT‐proBNP within a large, heterogeneous population of patients with suspected cardiovascular disease at risk of cardiovascular dysfunction and to compare it with the established diagnostic parameter BNP. Subjects and methods: NT‐proBNP and BNP were measured in 339 hospitalised patients undergoing diagnostic angiography (median age 66 years, 244 male vs. 95 female). Results: Median values of NT‐proBNP increased with worsening LV‐dysfunction and higher NYHA class. The area under the receiver operator characteristics curve (AUC) of NT‐proBNP for detecting severe systolic dysfunction or for detecting any systolic LV‐dysfunction was 0.83 and 0.77, respectively. The latter improved (AUC=0.81) when patients with clinically relevant heart disease like valvular dysfunction were included, independent of the haemodynamic values. Compared to BNP, NT‐proBNP tended to be more accurate in identifying lesser degrees of LV‐dysfunction. Conclusions: Even after optimisation of target criteria, there was still a substantial overlap of NT‐proBNP values between patients with and without relevant heart disease. Therefore, NT‐proBNP is not suitable as a screening test for LV‐dysfunction in the community. Nevertheless, because of its good negative predictive value, NT‐proBNP could be an easy and effective tool to rule out severe systolic LV‐dysfunction in high risk patients. No clinically significant advantage of BNP testing could be found.

This publication has 13 references indexed in Scilit: