Reference Intervals:
NTPro-BNP <125ng/L makes a diagnosis of congestive heart failure (CHF) very unlikely1 , while a NTPro-BNP >150ng/L is associated with increased 10 year mortality2.
Optimal sensitivity and specificity cut off for NTPro-BNP in CHF diagnosis in the ED was found with age-adjusted cut offs3,4
Age < 50 <450ng/L
Age 50 -75 <900ng/L
Age >75 <1800ng/L
1) Ponikowski P et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.Eur J Heart Fail 2016;18(8):891-975.
2) Taylor CJ et al. The potential role of NT-proBNP in screening for and predicting prognosis in heart failure: a survival analysis. BMJ Open 2014;4:e004675
3) Januzzi JL et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006;27(3):330-337.
4) Januzzi JL Jr et al. N-Terminal Pro-B-Type Natriuretic Peptide in the Emergency Department: The ICON-RELOADED Study. J Am Coll Cardiol. 2018;71(11):1191-1200.4)
MBS Indications:
NT-ProBNP is MBS-rebatable for the following indications:
1.For the diagnosis of heart failure in patients presenting with dyspnoea to a hospital Emergency Department
2. Testing in a patient with systemic sclerosis (scleroderma) to assess risk of pulmonary arterial hypertension (Maximum of 2 tests in a 12 month period)
3. Testing in a patient with diagnosed pulmonary arterial hypertension to monitor for disease progression (Applicable 4 times in any 12-month period)
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