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

  

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

RSCH same day, PRH within 24h.

Enquiries

Biochemistry (Automation)
 
Details