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B-Type Natriuretic Peptide (BNP)

Brain Natriuretic Peptide

Test Codes

Antrim: 19167, EPIC: LAB5012, BNP

Department

Chemistry

Specimen Collection Criteria

Collect: One Lavender-top EDTA tube. (Minimum Whole Blood: 3.0 mL)

Physician Office/Draw Specimen Preparation

Maintain whole blood refrigerated (2–8°C or 36–46°F) or at room temperature (20–26°C or 68–78.8°F) prior to transport. For delays in transport greater than 24 hours, centrifuge the specimen, transfer plasma to a plastic transport tube, and freeze (-20°C/-4°F or below). (Minimum: 1.0 mL plasma)

Preparation for Courier Transport

Transport: Whole blood, refrigerated (2–8°C or 36–46°F), or plasma, frozen (-20°C/-4°F or below). (Minimum: 3.0 mL whole blood or 1.0 mL plasma)

Rejection Criteria

• Serum specimens.
• Moderate to severely hemolyzed specimens.
• Plasma collected in Green-top, Blue-top or Gray-top tubes.

In-Lab Processing

Deliver immediately to the appropriate testing station.

Storage

Specimen Stability for Testing:

Whole Blood in EDTA
Room Temperature (20–26°C or 68–78.8°F): 24 hours
Refrigerated (2–8°C or 36–46°F): 24 hours
Frozen (-0°C/-4°F or below): Unacceptable

Plasma Aliquots
Room Temperature (20–25°C or 68–77°F): Unacceptable
Refrigerated (2–8°C or 36–46°F): 24 hours
Frozen (-20°C/-4°F or below): 9 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2–8°C or 36–46°F): 7 days

Laboratory

Canton Chemistry Laboratory
Dearborn Chemistry Laboratory
Farmington Hills Chemistry Laboratory 
Grosse Pointe Chemistry Laboratory 
Lenox Main Laboratory
Livonia Main Laboratory
Royal Oak Automated Chemistry Laboratory 
Troy Chemistry Laboratory
Taylor Chemistry Laboratory
Trenton Chemistry Laboratory
Wayne Chemistry Laboratory 

Performed

Sunday – Saturday, 24 hours a day.
STAT results available within 1 hour of receipt in the Laboratory.
Routine results available within 4 hours.

Reference Range

Less than or equal to 100 pg/mL.

Test Methodology

Chemiluminescence.

Interpretation

BNP is produced by the heart in response to increased wall tension. The BNP level is increased in patients with congestive heart failure (CHF), its level being proportional to the stage of heart failure (NYHA I-IV). Currently the test is approved as a diagnostic aid in CHF and as a prognostic indicator in acute coronary syndromes.

Clinical Utility

Recommendations for use are:

• When CHF is suspected, but the diagnosis is not clear cut.
• Consider re-ordering BNP 1-2 days prior to hospital discharge, looking for a decrease of greater than 50% of admission level or an absolute level of less than 500 pg/mL. Patients with this type of decline are much less likely to be re-admitted because of CHF in the next few weeks.
• Frequent or daily monitoring of BNP is not appropriate and is strongly discouraged.
• Interpretation of BNP level:
  • Less than or equal to 100 pg/mL: CHF unlikely, particularly if less than 50 pg/mL.
  • 101 - 500 pg/mL: Acute heart failure likely but also consider other conditions (pulmonary embolus, renal failure, sepsis, coronary ischemia).
  • Greater than 500 pg/mL: CHF very likely.

Reference

1. Maisel AS, McCullough PA. Cardiac natriuretic peptides: a key window to cardiac function. Rev Cardiovasc Med. 2003;4(suppl 4):S3–S12.
2. Mueller C et al. Use of BNP in the evaluation and management of acute dyspnea. N Engl J Med 2004;350:647–54.
3. McCullough PA et al. B-type natriuretic peptide and clinical judgement in emergency diagnosis of heart failure. Circulation 2002; 106:416–422.
4. Maisel AS et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 2002;347:161–7.

CPT Codes

83880
LOINC:   30934-4

Contacts

Last Updated

10/3/2023