N-terminal prohormone of brain natriuretic peptide

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The N-terminal prohormone of brain natriuretic peptide (NT-proBNP or BNPT) is a prohormone with a 76 amino acid N-terminal inactive protein that is cleaved from the molecule to release brain natriuretic peptide 32 (BNP, also known as B-type natriuretic peptide).

Both BNP and NT-proBNP levels in the blood are used for screening, diagnosis of acute

myocardial ischemia, and severity of aortic valve stenosis.[2][3][4][5][6][7]

Blood levels

Upper limit (95th percentile) of blood ranges
for NT-proBNP in healthy people[8]
Sex Age Limit
in pg/mL
Male 19-44 yrs 93
45-54 yrs 138
55-64 yrs 177
65-74 yrs 229
> 75 yrs 852
Females 19-44 yrs 178
45-54 yrs 192
55-64 yrs 226
65-74 yrs 353
> 75 yrs 624
Interpretation Age Range
Congestive heart failure
likely
<
75 years
> 125 pg/mL[9]
>75 years >450pg/mL[9]

There is no level of BNP that perfectly separates patients with and without heart failure.[10]

In screening for

cardiovascular death, hospitalization with heart failure due to progression of aortic valve stenosis, or aortic valve replacement surgery).[12] In severe aortic valve stenosis, NT-proBNP provide important prognostic information beyond clinical and echocardiographic evaluation.[13]

Test usage in a clinical setting

Canada

While discussed in Canadian medical journals in the mid to late 2000s,[14] the test is not widely used. It was only approved for use in Alberta in February 2012.[15]

Test usage in the life insurance industry

The test has been widely used in the life insurance industry to screen applicants as part of the routine requirements when applying for a life insurance policy. It is also inexpensive and can be measured from blood samples routinely drawn as part of the application process. The test can be used to evaluate for a number of health conditions.[7][16][17]

See also

  • Brain natriuretic peptide

References

  1. PMID 14872150
    .
  2. PMID 15389242
    .
  3. PMID 12020494
    .
  4. PMID 10995414
    .
  5. PMID 17062957
    .
  6. S2CID 33475819
    .
  7. ^
    PMID 35171199
    .
  8. ^ "N-terminal-pro-BNP". LABORATORY SERVICES HANDBOOK. The University of Iowa (UIHC), Department of Pathology. 28 May 2020. Archived from the original on 2008-10-11. Showing 95th percentiles. Epic Lab Code: LAB649.
  9. ^
    ISBN 978-1-58528-180-0
    .
  10. PMID 12124404
    .
  11. ^
    doi:10.1309/LMW0U87COTHXGELF
    .
  12. PMID 35171199
    .
  13. PMID 15117847
    .
  14. PMID 17324304
    .
  15. ^ "B-type Natriuretic Peptide (BNP) & NT-proBNP Test Implementation". Alberta Health Services. Archived from the original on 22 April 2015. Retrieved 3 January 2013.
  16. ^ George H (2010). "NT-proBNP The Finest Cardiovascular Screening and Reflexive Test In the History of Life Underwriting" (PDF). Insureintell. Retrieved 11 July 2016.
  17. PMID 25004594
    .

External links
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