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Test Code LAB8638 NT-Pro B-Type Natriuretic Peptide, Serum

Additional Codes

PBNP1


Necessary Information


Patient's age and sex are required.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Within 2 hours of collection, centrifuge the specimen.

2. For red-top tubes, aliquot the serum into a plastic vial.


Secondary ID

615897

Useful For

Aiding in the diagnosis of congestive heart failure using serum specimens

Testing Algorithm

For more information see Amyloidosis: Laboratory Approach to Diagnosis

Method Name

Electrochemiluminescence Immunoassay

Specimen Type

Serum

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Frozen (preferred) 365 days
  Refrigerated  7 days

Reject Due To

Gross hemolysis Reject

Reference Values

Males

0-2 days: 321-11,987 pg/mL

3-11 days: 263-5918 pg/mL

12 days-1 month: Not applicable

2 months-1 year: 37-646 pg/mL

2 years: 39-413 pg/mL

3 years-6 years: 23-289 pg/mL

7 years-14 years: ≤157 pg/mL

15 years-18 years: ≤158 pg/mL

19-39 years: <79 pg/mL

40-44 years: ≤72 pg/mL

45-54 years: ≤87 pg/mL

55-64 years: ≤88 pg/mL

≥65 years: ≤540 pg/mL

 

Females

0-2 days: 321-11,987 pg/mL

3-11 days: 263-5918 pg/mL

12 days-1 month: Not applicable

2 months-1 year: 37-646 pg/mL

2 years: 39-413 pg/mL

3 years-6 years: 23-289 pg/mL

7 years-14 years: < or=157 pg/mL

15 years-18 years: ≤158 pg/mL

19-39 years: <160 pg/mL

40-44 years: ≤162 pg/mL

45-54 years: ≤141 pg/mL

55-64 years: ≤226 pg/mL

≥65 years: ≤540 pg/mL

Interpretation

Younger than 50 years:

N-terminal pro-B-brain natriuretic peptide (NT-proBNP) values below 300 pg/mL have a 99% negative predictive value for excluding acute congestive heart failure (CHF). A cutoff of 1200 pg/mL for patients with an estimated glomerular filtration rate (eGFR) below 60 yields a diagnostic sensitivity and specificity of 89% and 72% for acute CHF. NT-proBNP values greater than 450 pg/mL are consistent with CHF in adults younger than 50 years.

 

50-75 years of age:

N-terminal pro brain natriuretic peptide values below 300 pg/mL have a 99% negative predictive value for excluding acute CHF. A cutoff of 1200 pg/mL for patients with an eGFR below 60 yields a diagnostic sensitivity and specificity of 89% and 72% for acute CHF. A diagnostic NT-proBNP cutoff of 900 pg/mL has been suggested for adults 50 to 75 years of age in the absence of kidney failure.

 

Older than 75 years:

N-terminal pro-brain natriuretic peptide values below 300 pg/mL have a 99% negative predictive value for excluding acute CHF. A cutoff of 1200 pg/mL for patients with an eGFR below 60 yields a diagnostic sensitivity and specificity of 89% and 72% for acute CHF. A diagnostic NT-proBNP cutoff of 1800 pg/mL has been suggested for adults older than 75 years in the absence of kidney failure.

 

N-terminal pro-brain natriuretic peptide levels are loosely correlated with New York Heart Association (NYHA) functional class (see Table).

 

Table. Interpretive Levels for CHF

Functional class

5th to 95th percentile

Median

I

31-1110 pg/mL

377 pg/mL

II

55-4975 pg/mL

1223 pg/mL

III

77-26,916 pg/mL

3130 pg/mL

IV

*

*

*In a Mayo Clinic study of 75 patients with CHF, only 4 were characterized as class IV. Accordingly, range and median are not provided.

Method Description

This test is an automated, double-incubation sandwich assay. In the first incubation, antigen from the patient specimen reacts with biotinylated monoclonal sheep N-terminal pro-brain natriuretic peptide (NT-proBNP) antibody and monoclonal NT-proBNP antibody labeled with ruthenium complex. During the second incubation, streptavidin-labeled microparticles are added, and the resulting complex is bound to the solid-phase via biotin-streptavidin interaction. The resulting reaction mixture is aspirated into the measuring cell where the microparticles are magnetically captured onto the surface of an electrode. Unbound substances are washed away. Voltage is then applied to the electrode, which induces chemiluminescent emission that is measured by a photomultiplier. Results are obtained by comparing this measurement against the calibration curve. The Roche E Modular NT-proBNP assay standardization is traceable to an internal Roche standard. Assigned values for calibrators are traceable to this standardization.

 

The Roche NT-proBNP assay is automated and more precise than the Biosite BNP assay used previously. In addition, in vitro NT-proBNP is more stable than BNP.(Package insert: ProBNP II, Roche Diagnostics; V 3.0, 08/2023)

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 to 2 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

83880

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PBNP1 NT-Pro BNP, S 83107-3

 

Result ID Test Result Name Result LOINC Value
PBNP1 NT-Pro BNP, S 83107-3