Capillary B-type natriuretic peptide (BNP) testing is attractive in outpatient and emergency settings. The aim of this study was to perform an evaluation of the clinical performances of capillary BNP testing as compared with venous whole blood and plasma point-of-care (POC) BNP as well as plasma N-terminal (NT) proBNP central laboratory testing.
BNP was measured with a novel single epitope POC assay (Minicare® BV, Eindhoven, The Netherlands) and NT-proBNP with a central laboratory assay (Roche Diagnostics®, Vienna, Austria).
BNP and NT-proBNP were measured in 269 patients of a Department of Cardiology (mean age 67.9 ± 13 years, 26.4% females). Capillary BNP very closely correlated with whole blood venous BNP (r = 0.99, p < 0.001). There was also a close correlation of plasma BNP and NT-proBNP concentrations (r = 0.79, p < 0.001). The diagnostic performances of capillary BNP, whole blood venous BNP, plasma BNP and plasma NT-proBNP for acute heart failure (areas under receiver operating characteristic curves [AUC ROC]: 0.73–0.77) or systolic left ventricular dysfunction in the whole study population (AUC ROC: 0.72–0.76) did not differ significantly. All were significant independent predictors of cardiovascular death during follow-up of the whole study population.
Our study for the first time demonstrated a very close correlation of capillary and venous whole blood or plasma BNP concentrations using the same BNP assay in a large patient cohort. The diagnostic performances of different BNP specimens did not differ significantly, and no significant differences between BNP and NT-proBNP were found either.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Data analysis, interpretation and writing of the manuscript was performed from co-authors of the Department of Internal Medicine III – Cardiology and Angiology, Medical University Innsbruck, A-6020 Innsbruck Austria.
Research funding: This clinical study was supported by Philips BG Emerging Businesses (Eindhoven, The Netherlands) by financing a study nurse for patient screening and performing BNP point-of-care testing and providing the required reagents, equipment and training.
Employment or leadership: Some co-authors (LvL, VS, JN, AvR) were employees of Philips BG Emerging Businesses at the time when this study was carried out.
Honorarium: None declared.
Competing interests: The funding organisation(s) played no role in the analysis and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
1. Thygesen K, Mair J, Mueller C, Huber K, Weber M, Plebani M, et al. Recommendations for the use of natriuretic peptides in acute cardiac care: a position statement from the Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. Eur Heart J 2012;33:2001–6.10.1093/eurheartj/ehq509Search in Google Scholar PubMed
2. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37:2129–200.10.1002/ejhf.592Search in Google Scholar PubMed
3. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Colvin MM, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation 2017;136:e137–61.10.1161/CIR.0000000000000509Search in Google Scholar PubMed
4. De Vecchis RD, Ariano C. Measuring B-type natriuretic peptide from capillary blood or venous sample: is it the same? Cardiol Res 2016;7:51–7.10.14740/cr468eSearch in Google Scholar PubMed PubMed Central
5. Pontera C, Masotti S, Franzini M, Emdin M, Passino C, Zucchelli GC, et al. Comparison between BNP values measured in capillary blood samples with POCT method and those measured in plasma venous samples with an automated platform. Clin Chem Lab Med 2015;53:e125–7.10.1515/cclm-2014-0873Search in Google Scholar PubMed
6. Montfort A, Da Silva K, Vodovar N, Gayat E, Cohen-Solal A, Manivet P. Clinical evaluation of the Heart Check system, a new quantitative measurement of fresh capillary BNP. Biomark Med 2015;9:1323–30.10.2217/bmm.15.95Search in Google Scholar PubMed
7. Taylo KS, Verbakel JY, Feakins BG, Price CP, Perera R, Bankhead C, et al. Diagnostic accuracy of point-of-care natriuretic peptidetesting for chronic heart failure in ambulatory care: systematic review and metaanalysis. Br Med J 2018;361:k1450.10.1136/bmj.k1450Search in Google Scholar PubMed PubMed Central
8. Reenen AV, Berger M, Moreau E, Bekx E, Bruinink T, Kemper D, et al. Analytical performance of a single epitope B-type natriuretic peptide sandwich immunoassay on the Minicare platform for point-of-care diagnostics. Pract Lab Med 2019;15:e00119.10.1016/j.plabm.2019.e00119Search in Google Scholar PubMed PubMed Central
9. Bruls DM, Evers TH, Kahlman JA, van Lankvelt PJ, Ovsyanko M, Pelssers EG, et al. Rapid integrated biosensor for multiplexed immunoassays based on actuated magnetic nanoparticles. Lab Chip 2009;9:3504–10.10.1039/b913960eSearch in Google Scholar PubMed
10. Dittmer WU, Evers TH, Hardeman WM, Huijnen W, Kamps R, de Kievit P, et al. Rapid, high sensitivity, point-of-care test for cardiac troponin based on optomagnetic biosensor. Clin Chim Acta 2010;411:868–73.10.1016/j.cca.2010.03.001Search in Google Scholar PubMed
11. Tamm NN, Semenov AG, Seferian KR, Bereznikova AV, Murakami MM, Apple FS, et al. Measurement of B-type natriuretic peptide by two assays utilising antibodies with different epitope specificity. Clin Biochem 2011;44:257–9.10.1016/j.clinbiochem.2010.09.030Search in Google Scholar PubMed
12. Rosjo H, Tamm NN, Kravdal G, Seferian KR, Hoiseth AD, Nygard S, et al. Diagnostic utility of a single-epitope sandwich B-type natriuretic peptide assay in stable coronary artery disease: data from the Akershus Cardiac Examination (ACE) 1 Study. Clin Biochem 2012;45:1269–75.10.1016/j.clinbiochem.2012.05.010Search in Google Scholar PubMed
13. Collinson PO, Barnes SC, Gaze DC, Galasko G, Lahiri A, Senior R. Analytical performance of the N-terminal pro B-type natriuretic peptide (NT-proBNP) assay on the Elecsys 1010 and 2010 analysers. Eur J Heart Fail 2004;6:365–8.10.1016/j.ejheart.2004.01.011Search in Google Scholar PubMed
14. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988;44:837–45.10.2307/2531595Search in Google Scholar
15. Hammerer-Lercher A, Pölzl G, Falkensammer G, Ludwig W, Hügel H, Puschendorf B, et al. B-type natriuretic peptide and N-terminal pro B-type natriuretic peptide are comparably useful for disease monitoring in heart failure. Int J Cardiol 2006;106:415–7.10.1016/j.ijcard.2005.01.016Search in Google Scholar PubMed
16. Gegenhuber A, Struck J, Poelz W, Pacher R, Morgenthaler NG, Bergmann A, et al. Midregional pro-A-type natriuretic peptide measurements for diagnosis of acute destabilized heart failure in short-of-breath patients: comparison with B-type natriuretic peptide (BNP) and amino-terminal proBNP. Clin Chem 2006;52:827–31.10.1373/clinchem.2005.065441Search in Google Scholar PubMed
17. Mair J, Falkensammer G, Hiemetzberger R, Ulmer H, Griesmacher A, Pachinger O. Head-to-head comparison of B-type natriuretic peptide (BNP) and NT-proBNP in daily clinical practice. Int J Cardiol 2008;124:244–6.10.1016/j.ijcard.2006.11.230Search in Google Scholar PubMed
18. Mair J, Lindahl B, Giannitsis E, Huber K, Thygesen K, Plebani M, et al. Will sacubitril-valsartan diminish the clinical utility of B-type natriuretic peptide testing in acute cardiac care? Eur Heart J Acute Cardiovasc Care 2017;6:321–8.10.1177/2048872615626355Search in Google Scholar PubMed
The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2019-0672).
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