N-terminal-pro-BNP

Label Mnemonic:	PBNP
Epic code:	LAB649
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Chemistry
6240 RCP
356-3527

Specimen(s):

Plasma

Collection Medium:

Plasma Separator Tube 4.5 mL

Minimum:

3 mL plasma separator tube top or TWO Microtainer^® devices.

Turn Around Time:

1 hour (upon receipt in laboratory)

Reference Range:

Age                        Reference Range (pg/mL)

Pediatric (boys and girls)
0-30 days                       263 - 6500
1 month - 11 months              37 - 1000
12 months - 35 months            39 - 675
3 years to 6 years               23 - 327
7 years to 14 years              10 - 242
15 years to 18 years              6 - 207

Males
19-44 years                       0 - 93
45-54 years                       0 - 138
55-64 years                       0 - 177
65-74 years                       0 - 229
75 years or older                 0 - 852

Females
19-44 years                       0 - 178
45-54 years                       0 - 192
55-64 years                       0 - 226
65-74 years                       0 - 353
75 years or older                 0 - 624

Reference ranges in adults reflect 95th percentiles for NT-pro-BNP 
levels in patients without congestive heart failure (CHF).  Knowledge 
of each individual patient's NT-proBNP range may be more useful than 
using similar cut-points for every patient.

For adult chronic CHF patients according to New York Heart Association 
(NYHA) Functional Class for NT-proBNP levels in pg/mL:

            Mean     5th percentile     95th percentile
Class I:    1016            33               3410
Class II:   1666           103               6567
Class III:  3029           126               10449
Class IV:   3465           148               12188

Pediatric reference ranges for patients 18 years and younger are from 
reference (1).

Among patients with dyspnea, NT-proBNP is highly sensitive for the 
detection of acute CHF.  In addition, a NT-proBNP < 300 pg/mL 
effectively rules out acute CHF, with 99% negative predictive value.  
Elevations in NT-proBNP levels may be observed in states other than 
left ventricular congestive failure including: acute coronary 
syndromes, right heart strain/failure (including pulmonary embolism 
and cor pulmonale), critical illness, and renal failure.  Falsely low 
NT-proBNP in CHF patients may be observed in increased body mass index.


References:
(1) Nir A et al.  Pediatr Cardiol 30:3-8, 2009.

Comments:

The N-terminal Pro-Brain Natriuretic Peptide (Pro-BNP) is an assay used as an aid in the diagnosis of individuals suspected of having congestive heart failure. The test is further indicated for the risk stratification of patients with acute coronary syndrome and congestive heart failure. The test may also be used as an aid in the assessment of increased risk of cardiovascular events and mortality in patients at risk for heart failure who have stable coronary artery disease.

NT-Pro-BNP is stable for three days at 2-8°C, so this assay may be added to existing PST tubes during those three days.

This test is also performed in the Iowa River Landing (IRL) clinical laboratory (for specimens drawn at that site).

Test Limitations:

Hemolysis  H = 1000
Lipemia    L = 1500
Icterus    I = 25

Biotin <3500 ng/mL

Methodology:

Electrochemiluminescence Immunoassay
Assay updated with increased tolerance to biotin on 05/02/23

CPT Code:

83880

See Additional Information:
Biotin Interference with Immunoassays