Access BNP & NT-proBNP Immunoassays

Natriuretic peptides reflect cardiac status and effects of therapy

Access BNP and NT-proBNP immunoassays are used to aid in the diagnosis of heart failure and left ventricular dysfunction.1
B‐type natriuretic peptide (BNP) is a cardiac hormone originating in the heart.2 In patients with heart failure, BNP and NT-proBNP levels are elevated.3 They can be assessed as important measures of cardiac function and diagnosis of heart failure.4

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Efficiently support diagnosis and assessment of heart failure severity with trustworthy results

B-type natriuretic peptide (BNP) and the N-terminal pro hormone BNP (NT-proBNP) are well established for use in diagnosis of heart failure. Following production, the prohormone is cleaved at a 1:1 ratio into NT-proBNP and BNP. (Fig. 1) BNP is involved in regulating blood volume.2 Blood levels of NT-proBNP and BNP increase when the left ventricle is stretched, as occurs during heart failure, a condition where the heart cannot pump enough blood.

Natriuretic peptides play a significant role in controlling cardiovascular function. The biologically active BNP ring is involved in cardiorenal homeostasis by stimulating diuresis and natriuresis. Both NT-proBNP and BNP biomarkers provide demonstrated benefit for heart failure patients in emergency and outpatient settings. Both NT-proBNP and BNP are included in standard of care guidelines for both the American College of Cardiology/American Heart Association5 and European Society of Cardiology.6

Laboratories can help clinicians deliver patient care with confidence for all stages of heart failure with Access NT-proBNP and BNP assays, highly sensitive and specific assays that aid clinicians in heart failure diagnosis, assessment of severity, and risk stratification.

Access BNP Cardiac
Figure 1. BNP and NT-proBNP production in the ventricular cardiac myocardium7

 

NT-proBNP
Increase accuracy in diagnosing heart failure with age-based cutoffs that improve specificity by 31% compared with a single cutoff strategy and specific information that supports interpretation of results in patients with comorbidities.
  • Results in under 11 minutes
  • Limit of Detection (LoD) ≤10 ng/L
  • Sample stability for 72 hours at room temperature
  • Compatible with serum, LiHep and EDTA plasma

BNP
Advance patient care with a strong predictor of clinical outcomes that supports diagnosis and assessment of severity for congestive heart failure and risk stratification of those with acute coronary syndrome.
  • Measures active hormone
  • General specificity of 98% using a threshold of 100 pg/mL
  • Total observed imprecision <7%
  • Analytical sensitivity: 1 pg/mL (95% confidence)

The Access NT-proBNP and BNP assays are not intended to be used in isolation; results should be interpreted in conjunction with other diagnostic tests and clinical information.

BNP NT-proBNP

Analytical Measuring Range

1 to 5000 pg/mL 10 to 35,000 ng/L (pg/mL)

Sample Type/Size

Plasma (EDTA) Serum, lithium heparin plasma, and EDTA

Time to First Result

≥16.2 minutes <11 minutes

Analytical Sensitivity

1 pg/mL (95% confidence)

Limit of Detection (LoD) ≤10 ng/L (pg/mL)

20% CV Limit of Quantitation (LoQ) ≤10 ng/L (pg/mL)

Calibrator Levels

0, and approximately 25, 100, 500, 2500, and 5000 pg/mL 0, and approximately 25, 100, 500, 2500, and 5000 pg/mL

Open pack stability

28 days 61 days

Calibration stability

28 days 28 days

Total Imprecision

<7% ≤4.0 ng/L (pg/mL) SD at concentrations ≤50 ng/L (pg/mL)
≤8.0% CV at concentrations >50 ng/L (pg/mL)

BNP & NT-proBNP Technical Bulletins

Triage BNP Technical Bulletin - Biotin Interference
This important information pertains to the Quidel Triage BNP Test for the Beckman Coulter® Access Family of Immunoassay Systems (Triage BNP for BCIS).

Access BNP Technical Bulletin – Biotin Interference
This important information pertains to the Access BNP test for the Access Family of Immunoassay Systems
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Q&A: Natriuretic Peptides 101

In this video series, Drs. Robert Christenson and W. Frank Peacock share their perspectives from the lab and Emergency Department on the value of BNP and NT-proBNP testing. Learn as they discuss the biology, clinical value, and confounding factors associated with BNP and NT-proBNP tests and how they are used in heart failure diagnostics and therapeutic monitoring.

Speakers:

Robert Christenson, PhD, DABCC, FAACC, FACC
Professor of Pathology & Professor of Medical and Research Technology
University of Maryland School of Medicine

 
Frank Peacock

W. Frank Peacock IV, MD, FACEP, FACC, FESC
Professor of Emergency Medicine and Vice Chair of Research for the Department of Emergency Medicine
Baylor College of Medicine

References:

1. Bionda C, Bergerot C, Ardail D, Rodriguez-Lafrasse C, Rousson R. Plasma BNP and NT-proBNP assays by automated immunoanalyzers: analytical and clinical study. Ann Clin Lab Sci. 2006;36(3):299-306.

2. Weber M, Hamm C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart. 2006;92(6):843-849. doi:10.1136/hrt.2005.071233

3. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147-239. doi:10.1016/j.jacc.2013.05.019

4. Chien T-I, Chen H-H, Kao J-T. Comparison of Abbott AxSYM and Roche Elecsys 2010 for measurement of BNP and NT-proBNP. Clin Chim Acta. 2006;369(1):95-99. doi:10.1016/j.cca.2006.01.017

5. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e876-e894. doi:10.1161/CIR.0000000000001062

6. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599-3726. doi:10.1093/eurheartj/ehab368

7. Kim YS, Karisa N, Jeon WY, Lee H, Kim Y-C, Ahn J. High-level production of N-terminal pro-brain natriuretic peptide, as a calibrant of heart failure diagnosis, in Escherichia coli. Appl Microbiol Biotechnol. 2019;103(12):4779-4788. doi:10.1007/s00253-019-09826-8