NT-proBNP
NT-proBNP (N-terminal pro-B-type natriuretic peptide) is the inactive piece snipped off proBNP when your heart-muscle cells are stretched, by high pressure in the ventricle wall or by volume overload. It lasts longer in blood than BNP itself (about 60 to 120 minutes), which makes it more stable to measure. It is a central marker for diagnosing and gauging heart failure. In non-acute settings, a value above 125 pg/mL is widely used to rule heart failure out. The 2023 ESC HFA guidance sets age-stratified rule-in thresholds for the non-acute community setting: 125 pg/mL under age 50, 250 pg/mL for ages 50 to 74, and 500 pg/mL for age 75 and up. (Acute-setting rule-in cutoffs, 450/900/1800 pg/mL, are higher.) Beyond known heart failure, a mildly raised NT-proBNP in the general population independently links to atrial fibrillation, coronary artery disease, chronic kidney disease, and all-cause death. So it is increasingly used as a marker of quiet, early cardiac stress in longevity assessments.
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Sources
- Januzzi JL Jr, Camargo CA, Anwaruddin S, Baggish AL, Chen AA, Krauser DG, et al.. (2005). The N-terminal Pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. *American Journal of Cardiology*doi:10.1016/j.amjcard.2004.12.032
- Wang TJ, Larson MG, Levy D, Benjamin EJ, Leip EP, Omland T, et al.. (2004). Plasma natriuretic peptide levels and the risk of cardiovascular events and death. *New England Journal of Medicine*doi:10.1056/NEJMoa031994