Interviewer: So, one of our attendees was wondering, should physicians use BNP over NT- proBNP in routine clinical practice?
Interviewee: Well, not necessarily. Both BNP and NT-proBNP are, as I’ve mentioned, are useful to help physicians in the diagnosis and management of patients with heart failure, especially if they’re unsure with regard to the clinical presentation of those patients. And as I just mentioned, they are particularly useful as a rule out test because they have a very high negative predictive value. So, the answer is not necessarily. They’re both valuable markers.
Interviewer: Brilliant. Thank you for that. So, question number two is, do any vendors offer both BNP and NT-proBNP assays?
Interviewee: Well, at this time actually, only Siemens has both BNP and NT-proBNP. There are a number of other assays on the market for BNP, and others for NT-proBNP. But vendors, except for Siemens, they either have BNP or NT- proBNP.
Interviewer: Brilliant. So, another question that we had in is, is it better to use BNP or NT-proBNP in patients with renal failure?
Interviewee: Well, here again, they’re both can be elevated as I showed on one of those slides. Both BNP and NT-proBNP can be elevated as GFR decreases, particularly less than around 60 or so, even in the absence of heart failure. So, as a result, physicians must be aware of this. I guess you’d call a limitation of the next word of peptides when interpreting elevated values. But remember they’re both again, both effective as a rule out test even in patients with renal insufficiency.
Interviewer: Fantastic. So the next question is, as physicians continue to prescribe and trust over the treatment of heart failure, will BNP become obsolete?
Interviewee: No, absolutely not. BNP may show this modest increased, or maybe not. More studies may be needed. Sorry. But as our recent study suggest, there may be no increase at all, in either case, along with NT-proBNP. BNP is and will remain an important biomarker to help physicians with the diagnosis and management of patients suspected of heart failure. The choice of the natural peptide really is one that is going to be a local decision generally to be made between the medical staff in the laboratory.
Interviewer: Okay. So, we have had some more questions from some attendees. So, one of our attendees is wondering, at what point is surgery or a defibrillator recommended for a [inaudible 00:03:39]?
Interviewee: Well, heart failure is generally treated with medication, and not necessarily with surgery. But if the underlying cause may be a valvular problem, then surgery may be indicated.
Interviewer: Okay, great. I think we’ve got time for one more question. One of our attendees is wondering, is there a rule of thumb to compare BNP versus NT-proBNP values when consolidating a mixed set of values?
Interviewee: Well, that’s a good question. I probably should have included that in the presentation. I’m glad whoever asked that question, and the answer is, no. But this comes up frequently when a lab is switching from one method to the other. Physicians were used to one of the values, and now they’re getting the other. Let’s say they were going from BNP to NT-proBNP, and they’re getting an NT-proBNP value of some number. In their head they’re saying, “Well, I wonder what the BNP would have been in this patient,” And there’s no simple number I can say. Well, you can divide the NT-proBNP by some number and come up with the equivalent BNP. No such number exists, so there’s no easy correlation between the two. Now there is a correlation. They both tend to increase together, but numerically you can’t come up with a simple equation, or simple divisor to say, “Divide the NT by some number, or multiplier to multiply BNP to get an NT-proBNP value. Good question.
Interviewer: Fantastic. Thank you so much. Unfortunately, we’ve got time for today.