Download NT ProBNP - Camden GP Website

NT ProB Type Natriuretic peptides (NT ProBNP) –
Change in reporting of units from pmol/L to ng/L as of 19/09/2016.
NT ProBNP measurements are used to ‘rule out’ chronic heart failure in Primary care or
secondary care prior to referral for echocardiography and a specialist opinion in a one stop
diagnostic clinic as recommended by NICE.
NICE has published an algorithm on the use of NT ProBNP. This is also in accordance with a
drive to harmonise units of measurements for many analytes.
We have also had some problems with IT systems in some GP practices where the units are
changed automatically from the current units of pmol/L to ng/L without any alteration in
comments associated with it causing confusion.
The laboratory is changing the reporting units to ng/L and comments based on NICE
recommendations will be assigned to the results.
The change is supported by
Royal free NHS Foundation Trust- Royal Free site only
University College Hospital NHS Foundation Trust
Whittington Hospital and
North Middlesex University Hospital.
The following cut offs taken from NICE CG 108 will be applied with the comments
https://www.nice.org.uk/guidance/cg108
NT-proBNP
<400 ng/L
Heart failure unlikely;
Consider other causes of SOB.
NT-proBNP
400 - 2000 ng/L
Raised levels; refer to rapid access heart failure clinic to be seen
Within 6 weeks. To discuss further, please contact*
NT-proBNP
>2000 ng/L
High levels; refer to rapid access heart failure clinic to be seen
Within 2 weeks. To discuss further, please contact*
Please be aware that:
1 A raised NT-proBNP level does not confirm Heart failure but indicates the need for further assessment and
patients should not be told they have HF on the basis of an elevated NT-proBNP alone.
2 High levels can have causes other than heart failure (LVH) ischaemia, right ventricular overload, hypoxaemia,
and GFR <60ml/min, sepsis, COPD, diabetes, age> 70y and liver cirrhosis
3. Obesity, diuretics, ACE inhibitors, beta blockers, ARBs and aldosterone antagonists can reduce NT-proBNP
concentration
A routine serum (clotted sample) is required for analysis. Appropriate contact numbers will
be included for the Heart failure teams from different hospitals so as to enable appropriate
advice and referrals.
Appendix 1
Contacts for Heart Failure Teams: these contacts will appear as part of the comment for the
respective hospitals
1. North Middlesex Hospital
[email protected]
2. Royal Free Hospital: The Heart Failure Team/ Cardiology secretaries on 38017
3. Whittington Hospital: The Heart Failure Team on 020 7288 5988 or the Cardiology
secretaries on 020 7288 5290/92.
4. University College Hospital: [email protected]
Heart Failure Leads for the different hospitals
North Middlesex Hospital - Dr Amal Muthumala
[email protected]
Royal Free Hospital : Dr Carol Whelan
[email protected]
Whittington Hospital : Dr Suzanna Hardman
[email protected]
University College Hospital: Dr Simon Woldman
[email protected]
Laboratory Leads
Dr D.R Nair Consultant Chemical Pathologist
Clinical lead for Royal Free NHS Foundation Trust and North Middlesex hospital
Direct line 0207 4726694 Secretaries: 35082/35083
[email protected]
Mrs Joanne Morris Consultant clinical scientist
Whittington Hospital
[email protected]
Dr Gill Rumsby Consultant Clinical Scientist
University College Hospital NHS foundation Trust
[email protected]