From the Guidelines
NT-proBNP is preferred over BNP for predicting mortality, morbidity, hospitalisation for cardiac failure, left ventricular dysfunction, and coronary artery disease due to its decreased sensitivity to renal function deterioration and more stable structure. When comparing NT-proBNP to BNP, several key differences emerge. NT-proBNP has a longer half-life of 1-2 hours, compared to BNP's half-life of approximately 20 minutes 1. This longer half-life makes NT-proBNP more stable for testing and less sensitive to rapid haemodynamic shifts. Some key points to consider when choosing between NT-proBNP and BNP include:
- NT-proBNP has a slightly wider detection range compared to BNP 1
- Both markers perform well when prognosticating, but NT-proBNP may be superior to BNP for predicting various cardiac outcomes 1
- The choice between monitoring BNP or NT-proBNP remains unclear, but good clinical correlation between the two hormones has been shown 1
- NT-proBNP levels may be less sensitive to rapid haemodynamic shifts due to its more stable structure compared to BNP 1
From the Research
Comparison of ProBNP and BNP
- ProBNP and BNP are both natriuretic peptides used in the diagnosis and management of heart failure 2, 3, 4.
- BNP and NT-proBNP levels are increased in persons with heart failure, and low levels of these peptides can rule out heart failure 3.
- NT-proBNP is a 76-amino acid peptide created during cleavage of the precursor molecule, Pro B-type natriuretic peptide (ProBNP) 4.
- Both BNP and NT-proBNP are useful in diagnosing heart failure, guiding therapy, and predicting prognosis 2, 3, 4.
Clinical Applications
- NT-proBNP is of significant diagnostic value in patients presenting with possible heart failure and is an important prognostic factor in this condition and other cardiovascular diseases 4.
- BNP and NT-proBNP testing can be used to identify patients with heart failure with reduced ejection fraction (HFrEF) and to monitor their condition 5.
- NT-proBNP concentrations can vary across different populations and subpopulations within HFrEF 5.
Limitations and Factors Affecting Measurement
- There are some clinical conditions, such as obesity, renal insufficiency, and anemia, for which NP measurement is not diagnostic 2.
- Antipsychotic medication can influence the plasma concentration of NT-proBNP, suggesting a possible method to identify high-risk patients for cardiovascular adverse effects 6.
- Factors such as age, sex, and smoking status can affect NT-proBNP values 6.