Dr Januzzi: BMI stratified cut-off values for NT-proBNP are, not recommended. The reason is, the age-stratified approach of 450 pg/mL, 900 pg/mL and 1800 pg/mL for people less than 50 yrs, 50 to 75 yrs, greater than 75 yrs, really addresses (to a large extent) the BMI differences. Younger patients tend to be heavier and […]
What are your views on improvement in NT-proBNP but no improvement in clinical endpoints?
Dr Januzzi: NT-proBNP changes from minute to minute, from hour to hour. The studies that have shown improvement in NT-proBNP but no improvement in clinical endpoints were studies that gave a short -term treatment. For example, Levosimendan (calcium sensitizer) given for a week, shows the NT-proBNP decrease, but then the endpoints were a month later or […]
Are NT-proBNP results from different companies transferable?
Dr Januzzi: In the early days, when NT-proBNP and BNP were first released, all of the NT-proBNP assays were quite similar in terms of reference ranges because they were all based on the same antibodies. The BNP assays out in the market are completely different; as they are based on different capture and detection antibodies. More […]
Are there different cut-offs for NT-proBNP in patients with heart failure preserved (HEpEF) or reduced ejection fraction (HFrEF) conditions?
Dr Januzzi: Different cut-offs for preserved ejection fraction (HFpEF) are not recommended. However, it is recognised that preserved EF heart failure may be more likely to be below the rule in the threshold. 300 pg/mL is the rule out level and then from 300 pg/mL up to 1800 pg/mL is a grey zone. Patients with preserved […]
Can NT-proBNP be used in a paediatric patient?
Dr Januzzi: If NT-proBNP is measured in a neonate or in a baby that’s about one or two days old, it is in the 5000 pg/mL to 10,000 pg/mL range. This has to do with the fact that in the peripartum period, at the near term and then in delivery, the infant’s cardiac output is […]