N-terminal prohormone of brain natriuretic peptide.
(NT-ProBNP)
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.
Both BNP and NT-proBNP levels in the blood are used for screening, diagnosis of acute congestive heart failure (CHF).
They may be useful to establish prognosis in heart failure, as both markers are typically higher in patients with worse outcome.
The plasma concentrations of both BNP and NT-proBNP are also typically increased in patients with asymptomatic or symptomatic left ventricular dysfunction and is associated with coronary artery disease and myocardial ischemia.
Upper limit (95th percentile) of blood ranges for NT-proBNP in healthy people in pg/L
Male < 45 yrs 90
45-59 yrs 140
55-64 yrs 180
65-74 yrs 230
> 75 yrs 850
Females < 45 yrs 180
45-54 yrs 190
55-64 yrs 230
65-74 yrs 350
> 75 yrs 620
Congestive heart failure likely
<75 years > 125 pg/mL
>75 years >450pg/mL
There is no level of BNP that perfectly separates patients with and without heart failure.
NT-proBNP Predicts Cardiac Complications After Noncardiac Surgery
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.
It measures both stretch in the heart and also cardiac ischemia that is commonly not recognized clinically.
Both BNP and NT-proBNP levels in the blood are used for screening, diagnosis of acute congestive heart failure (CHF) and may help establish prognosis in heart failure.
Both markers are typically higher in patients with worse outcome.
The plasma concentrations of both BNP and NT-proBNP are also typically increased in patients with asymptomatic or symptomatic left ventricular dysfunction.
The plasma concentrations of both BNP and NT-proBNP are also typically associated with coronary artery disease and myocardial ischemia.
Upper limit of blood ranges for NT-proBNP in healthy people:
Male < 45 yrs 90
45-59 yrs 140
55-64 yrs 180
65-74 yrs 230
> 75 yrs 850
Females < 45 yrs 180
45-54 yrs 190
55-64 yrs 230
65-74 yrs 350
> 75 yrs 620
Congestive heart failure likely <75 years > 125 pg/mL
>75 years >450pg/mL
There is no level of BNP that perfectly separates patients with and without heart failure.
Assessment of N-terminal pro-B-type natriuretic peptide (NT-proBNP) level prior to noncardiac surgery may predict whether the patient might experience adverse cardiac outcomes, such as myocardial injury or vascular death after noncardiac surgery.
Higher levels of preoperative NT-proBNP are associated with higher rates of cardiovascular events.
Patients whose levels were >1500 pg/mL had a fivefold increased risk for the primary outcome, a composite of vascular death and myocardial injury at 30 days, compared to patients with levels <100 pg/mL.
NT-proBNP currently used to predict perioperative cardiac risk.
This test can measure whether adults undergoing noncardiac surgery whether they are going to suffer a major cardiovascular event or even death.
Preoperative NT-proBNP values were found to be statistically significantly associated with 30-day all-cause mortality:
≤100 pg/mL: 0.3%
100 to ≤200 pg/mL: 0.7%
200 to ≤1500 pg/mL: 1.4%
≥1500 pg/mL: 4.0%
NT-proBNP can help identify patients who are at higher risk for postoperative cardiac events and may identify the patients who benefit from perioperative troponin monitoring.