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Rapid detection and efficient aid in diagnosis of acute heart failure with NT-proBNP testing

NT-proBNP is an essential cardiac biomarker that aids in the diagnosis of heart failure

NT-proBNP is not available in the US.

Affecting about 26 million people worldwide, heart failure is an acute life-threatening disorder and a major global health problem [1].

It is a complex and progressive clinical condition in which the heart can’t pump enough blood to meet the body’s demands.

Patients with reduced cardiac output usually present with shortness of breath and fatigue. The condition progresses rapidly, and quick and correct differential diagnosis of this condition is critical, as late or incorrect diagnosis delays the initiation of the appropriate treatment, increasing morbidity and mortality as well as treatment costs.

Natriuretic peptides, such as NT-proBNP, are proven biomarkers to reduce diagnostic uncertainty and to improve diagnostic accuracy in patients presenting with shortness of breath and potential heart failure [2]. 

Basic ScienceNT-proBNP testing as an aid in diagnosing heart failure

Natriuretic peptides are released into the bloodstream by the ventricles of the heart in response to increased cardiac wall stress and volume overload.

Diagnosing heart failure is a difficult clinical challenge and is initially based on a physical exam and the patient’s medical history. For an improved diagnosis of heart failure, tests such as ECG, chest X-ray, echocardiography, and heart failure biomarkers, such as NT-proBNP, have proven useful. The higher the levels of NT-proBNP, the more severe the heart failure.

Both BNP and NT-proBNP are incorporated into clinical practice guidelines for the diagnosis of heart failure as published by the American College of Cardiology, the American Heart Association, the Heart Failure Society of America, and the European Society of Cardiology [3-4]. 

NT-proBNP testing at the Emergency Department

Shortness of breath and fatigue are common symptoms of patients presenting to the emergency department and the underlying causes could be many. 

According to the 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, a plasma natriuretic peptide level like NT-proBNP should be measured in all patients presenting to the ED or CCU/ICU with acute shortness of breath and suspected acute heart failure. 

This is to help in the differentiation of acute heart failure from non-cardiac causes of shortness of breath, also known as acute dyspnea. 

Used in conjunction with other clinical information, rapid measurement of natriuretic peptides, such as NT-proBNP, in the emergency department has improved the evaluation and treatment of patients with acute dyspnea, reducing the time to discharge and the total cost of treatment [5-6]. 

Basic ScienceNT-proBNP as an aid in the risk stratification of patients with acute coronary syndrome and heart failure

Several studies indicate that elevated concentrations of NT-proBNP are independently associated with death and heart failure among patients with acute coronary syndrome [7-9].  

NT-proBNP is a consistent independent predictor of mortality and other cardiac composite endpoints for populations with coronary artery disease and diagnosed heart failure [12-15].

NT-proBNP tests at the point of care

Early diagnosis is crucial for the prognosis of heart failure. An NT-proBNP test at the point of care can play a significant role in improving clinical decision-making. 

The NT-proBNP assay on the AQT90 FLEX analyzer delivers lab-quality results on whole blood in less than 11 minutes. Simply load the test tube directly into the analyzer and begin testing.

So with access to fast and reliable test results for your patient, you’re one step closer to improving the time of diagnosing heart failure. When performing NT-proBNP testing at the point of care, time to decision is reduced, allowing for earlier initiation of treatment and improved clinical outcome. 

Delayed measurement of natriuretic peptides levels is strongly associated with delay in treatment for acute decompensated heart failure [10,11]. 

Quick facts on the NT-proBNP assay

  • Specimen types: venous whole blood and plasma
  • Sample tubes: fits most 13 × 75 mm standard tubes
  • No blood exposure: closed-tube system
  • No sample or assay preparation
  • High analytical performance
  • No presence of hook effect or carry-over
  • Hemolytic, lipemic and icteric samples do not interfere with the assay 

Assay specifics 

Turnaround time

< 11 min

CV% (plasma)

Within-lab CV% at conc. 101 (ng/L: 7.2 %)

95th % percentile

133 ng/L


Harmonized to correlate with results of 1st generation NT-proBNP assay on the Roche Elecsys 1010, Elecsys 2010 and MODULAR ANALYTICS E170 immunoassay analyzers. 



1. Ponikowski P et al. Heart failure: preventing disease and death worldwide. Wiley Online Library 2014; 1,1: 4-251. Bui AL., Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol 2011 January; 8:30–41
2. Bui AL., Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol 2011 January; 8:30–41. 
3. Seeger C et al. Acute care testing handbook 2014
4. Mallick A., Januzzi J.L. Biomarkers in Acute Heart Failure. Rev Esp Cardiol. 2015;6:514–525
5. Kragelund C et al. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. New Engl J Med 2005;352, 7: 666-75
6. Mueller C et al. N Engl J Med 2004;350:647-54 
7. De Lemos JA et al. N Engl J Med 2001; 345: 1014-1021
8. James SK et al. Circulation. 2003; 108:275-281
9. James SK et al. J Am Coll Cardiol. 2006 Sep 19;48(6):1146-54
10. Bingisser R et al. Am Heart J 2013; 166:614-621
11. Maisel AS et al. J Am Coll Cardiol 2008; 52:534-40
12. Richards AM, Nicholls MG, Yandle TG, et al: Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: new neurohormonal predictors of left ventricular function and prognosis after myocardial infarction. Circulation. 1998; 97(19): 1921-29
13. Ndrepepa G, Braun S, Niemöller K, et al: Prognostic value of N-terminal pro-brain natriuretic peptide in patients with chronic stable angina. Circulation 2005; 112(14): 2102-07
14. A, Puschendorf B, Mair J. Cardiac natriuretic peptides: new laboratory parameters in heart failure patients. Clin Lab 2001; 47: 265-67
15. Pfister R, Schneider CA. Natriuretic peptides BNP and NT-pro-BNP: established laboratory markers in clinical practice or just perspectives? Clin Chim Acta 2004; 349: 25-38

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