NT-proBNP

 

Alternative names, keywords

N-terminal pro B-type natriuretic peptide, BNP

Samples required

● Clotted blood (gold cap, 5 mL tube). 

Patient does not need to fast.

Test indications

  

Test information

Restrictions are in place for this test to prevent inappropriate repeat requesting. See minimum requesting intervals for more information and downloadable override form.

Factors affecting test performance/ results

In rare cases, interference due to extremely high titres of antibodies to analyte-specific antibodies, streptavidin or ruthenium can occur.

In extremely rare cases (global incidence: < 1 in 10 million), patients may show discrepant results when tested with the assay kit (values below lower detection limit) due to a NT-proBNP genetic variant.

Results should always be assessed in conjunction with the patient’s medical history, clinical examination and other findings.

Reference range

Reference ranges (see below for clinical cut-offs):

Age (years)

 Male Female

18 - 44

 < 86 pg/mL < 130 pg/mL

45 - 54

 < 121 pg/mL < 249 pg/mL

55 - 64

 < 210 pg/mL < 287 pg/mL

65 - 74

 < 376 pg/mL < 301 pg/mL

≥ 75

  486 pg/mL < 738 pg/mL

Source: Roche Cobas® Roche Cobas® Elecsys proBNP II kit insert 2023-12, V4.0

Non-HF causes of high NTproBNP: LVH, ischaemia, tachycardia, RV overload, hypoxaemia (including pulmonary embolism), renal dysfunction (GFR < 60 ml/min), sepsis, COPD, diabetes, age > 70 years, cirrhosis of the liver.
Obesity or treatment with diuretics, ACE inhibitors, beta-blockers, angiotensin II receptor antagonists (ARBs) and aldosterone antagonists can reduce levels of serum natriuretic peptides.

Clinical cut-offs

Please follow local guidance and pathways.

From NICE guideline NG106 Chronic heart failure in adults: diagnosis and management (published September 2018, updated September 2025), for patients with suspected heart failure:

< 400 pg/mL

 Heart failure less likely in untreated patient.

400 - 2000 pg/mL

 Refer for specialist assessment within 6 weeks.

above 2000 pg/mL

 Refer for specialist assessment within 2 weeks.

Acute heart failure is unlikely if NT-proBNP is less than 300 pg/mL (NICE CG187 Acute heart failure: diagnosis and management (published October 2014, last updated November 2021). Refer to local pathways.

Turnaround time

24 hours

Enquiries

Biochemistry (Automation)
 
Details