Not medically reviewed
Cardiac
N-terminal pro-B-type natriuretic peptide (NT-proBNP)
Not medically reviewed · Content last updated · 1 min read ·
This is the date the draft was written, not a medical review date.
The inactive N-terminal fragment cleaved from proBNP when BNP is released. It has a longer half-life than BNP and is used in the same diagnostic and prognostic context in heart failure.
Reference interval
| Conventional (pg/mL) | SI (ng/L) | |
|---|---|---|
| Adults | < 300 (upper limit) pg/mL | < 300 (upper limit) ng/L |
Specimen: Serum or plasma (EDTA or heparin) · Conventional × 1 = SI
Causes of high values
Heart failure, acute coronary syndrome, atrial fibrillation, valvular heart disease, pulmonary embolism and hypertension, advanced age, renal impairment (reduced clearance), sepsis.
Causes of low values
Obesity is associated with lower values. A value below the rule-out threshold makes heart failure unlikely.
Pre-analytical and method notes
In the acute setting a value below 300 pg/mL helps to rule out heart failure, while rule-in thresholds are age-stratified (higher in older patients); non-acute rule-out values are lower (about 125 pg/mL). Cut-offs vary by guideline, and values rise with age and with renal impairment. Reference intervals vary by laboratory, method and population; use the interval printed on the report.
References
- 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Society of Cardiology (2021) — Tier 2 (guidelines / primary literature)
- Rifai N, Horvath AR, Wittwer CT. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier, 6th edition (2018) — Tier 3 (textbook)
- Loscalzo J, et al.. Harrison's Principles of Internal Medicine. McGraw-Hill, 21st edition (2022) — Tier 3 (textbook)
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