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HelpTest Code PBNP1 NT-Pro B-Type Natriuretic Peptide, Serum
Additional Codes
CNE Order Code: ProBNP
Necessary Information
Patient's age and sex are required.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
Useful For
Aiding in the diagnosis of congestive heart failure using serum specimens
Testing Algorithm
For more information see Amyloidosis: Laboratory Approach to Diagnosis
Special Instructions
Method Name
Electrochemiluminescence Immunoassay
Reporting Name
NT-Pro BNP, SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 365 days | |
| Refrigerated | 7 days |
Reject Due To
| Gross hemolysis | Reject |
Reference Values
Males
0-2 day: 321-11,987 pg/mL
3-11 day: 263-5918 pg/mL
12 day-1 month: Not applicable
2 month-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 day: 321-11,987 pg/mL
3-11 day: 263-5918 pg/mL
12 day-1 month: Not applicable
2 month-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
Under 50 years of age:
N-terminal pro B-type 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 under 50 years of age.
50-75 years of age:
NT-proBNP 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.
Over 75 years of age:
NT-proBNP 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 over 75 years of age in the absence of kidney failure.
NT-Pro BNP 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. |
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Day(s) Performed
Monday through Sunday
Report Available
Same day/1 to 2 daysPerforming 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 |
Forms
If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.