What are the advantages of using NT-proBNP over BNP for testing heart failure in primary care?
The main advantages of using NT-proBNP for testing heart failure in primary care are that it has a greater sensitivity over a range of thresholds compared to BNP, has a longer stability in blood samples than BNP (days versus 4-6 hours), and is more useful to have NT-proBNP as the baseline peptide in case monitoring is needed in a patient with heart failure who is subsequently treated with a new drug. The NT-proBNP thresholds chosen as comparators are 400pg/ml 2010 NICE recommended threshold, 125pg/ml 2012 ESC threshold, 280pg/ml 2016 ESC threshold, and the optimal threshold found in one study included in the clinical review. A diagnostic strategy was also included where no NT-proBNP test is undertaken and all patients with suspected heart failure are referred for echocardiography plus specialist clinical assessment.