Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health Hospital, Kitakyushu, Japan.
Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
PLoS One. 2022 May 24;17(5):e0268895. doi: 10.1371/journal.pone.0268895. eCollection 2022.
Brain natriuretic peptide (BNP) is an essential cardiac biomarker for diagnosing heart failure and for prognoses in patients with various cardiac diseases. However, measurement requires immunological assays that are not available in every hospital. Recently, a novel BNP kit (Nanopia BNP-A, Sekisui Inc.; BNPn) that uses general-purpose, automated, biochemical analyzers has become commercially available. We assessed how its accuracy and utility compare with those of conventional immunological tests.
We retrospectively collected 1491 conventional BNP measurements (BNPc), which had been clinically indicated for BNP testing and for which residual samples were still stored in the laboratory. We measured BNP using the novel kit and determined the correlation of BNP levels between the two methods. We also assessed the predictive value of both BNP measurements for major cardiac events (MACEs). The analytical performance of both measuring methods was similar. Log-transformed BNP measured by both methods showed strong correlation (r = 0.92); however, log-transformed BNPn was significantly higher than log-transformed BNPc (p<0.001). BNPc of 200 ng/L was used to stratify patients into two groups. According to the regression formula between the two methods, we determined a cut-off value of BNPn as 250 ng/L. During a median of 15 months of follow-up, 43 MACEs developed. Both BNPc and BNPn were associated with MACEs. Kaplan-Meier survival analysis indicated that both BNPc and BNPn cut-off values stratified the high-risk group for prognostication. The diagnostic and prognostic utilities were proven even if the lower cut-off values (BNPc = 100 ng/L, BNPn = 130 ng/L) were employed.
A new BNP measurement using biochemical equipment provides prognostic value similar to that of conventional BNP analysis; thus, it should prove useful in hospitals in which conventional immunological examinations are not available.
脑钠肽（BNP）是诊断心力衰竭和各种心脏疾病患者预后的重要心脏生物标志物。然而，测量需要免疫测定法，而并非每个医院都能提供。最近，一种新型 BNP 试剂盒（Nanopia BNP-A，积水医疗株式会社；BNPn）已可商业化使用，该试剂盒使用通用的自动化生化分析仪。我们评估了其准确性和实用性与传统免疫检测方法相比如何。
我们回顾性收集了 1491 项临床指示进行 BNP 检测的常规 BNP 测量值（BNPc），并且实验室仍保留了这些检测的剩余样本。我们使用新型试剂盒测量 BNP，并确定两种方法之间的 BNP 水平相关性。我们还评估了两种 BNP 测量值对主要心脏事件（MACE）的预测价值。两种测量方法的分析性能相似。两种方法测量的对数转换 BNP 显示出很强的相关性（r=0.92）；然而，对数转换的 BNPn 明显高于对数转换的 BNPc（p<0.001）。我们使用 200ng/L 的 BNPc 将患者分层为两组。根据两种方法之间的回归公式，我们确定 BNPn 的截断值为 250ng/L。在中位数为 15 个月的随访期间，发生了 43 例 MACE。BNPc 和 BNPn 均与 MACE 相关。Kaplan-Meier 生存分析表明，BNPc 和 BNPn 截断值均可分层预测高危患者。即使使用较低的截断值（BNPc=100ng/L，BNPn=130ng/L），也证明了该检测的诊断和预后实用性。
使用生化设备进行新的 BNP 测量可提供与常规 BNP 分析相似的预后价值；因此，在无法进行常规免疫检查的医院，它应该是有用的。
