What are the brain natriuretic peptide (BNP) cutoff values?

Updated: Jan 08, 2018
  • Author: Donald Schreiber, MD, CM; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

The utility of BNP testing in the acute care setting is derived from the landmark Breathing Not Properly study and later studies. The initial Breathing Not Properly multicenter prospective study involved 1586 patients presenting to the ED with acute dyspnea. See Table 1, below.

Table 1. Evidence-Based BNP and NT-proBNP Cutoff Values for Diagnosing Heart Failure (Open Table in a new window)

Criterion

BNP, pg/mL

NT-proBNP, pg/mL

HF Unlikely

(LR-Negative)

HF Likely

(LR-Positive)

HF Unlikely

(LR-Negative)

HF Likely

(LR-Positive)

Age, y

>17

< 100 (0.13)*

>500 (8.1)*

-

-

>21

-

-

< 300 (0.02)

-

21-50

-

-

-

>450 (14)

50-75

-

-

-

>900 (5.0)

>75

-

-

-

>1800 (3.1)

Estimated GFR, < 60 mL/min

< 200 (0.13)

>500 (9.3)

-

-

BNP = B-type natriuretic peptide; GRF = glomerular filtration rate; HF = heart failure; LR = likelihood ratio; NPV = negative predictive value; NT-pro-BNP = N-terminal proBNP; PPV = positive predictive value; – = not specifically defined.

* Derived from Breathing Not Properly data (1586 emergency department [ED] patients, prevalence of HF = 47%). [4]

Derived from PRIDE data (1256 ED patients, prevalence of HF = 57%). [18, 19]

Derived from subset of Breathing Not Properly data (452 ED patients, prevalence of HF = 49%). [5]


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