Performance Characteristics of Four Automated Natriuretic Peptide Assays

Abstract

Measurement of circulating B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) can identify patients with heart failure and guide therapy. The limit of detection, linearity, imprecision, method comparison, analytic concordance, and reference intervals of the Access 2 BNP (Biosite, San Diego, CA), ADVIA Centaur BNP (Bayer Diagnostics, Tarrytown, NY), AxSYM BNP (Abbott Diagnostics, Abbott Park, IL), and E170 NT-proBNP (Roche Diagnostics, Indianapolis, IN) methods were evaluated. The Triage meter BNP assay (Biosite) was the comparison method. Imprecision testing showed total coefficients of variation of 4.1%, 4.4%, 5.5%, and 0.8% for the Access 2, ADVIA Centaur, AxSYM, and E170, respectively. Relative to the Triage meter, method comparison revealed a slope of 0.96 and r = 0.95, a slope of 0.77 and r = 0.92, a slope of 1.13 and r = 0.94, and a slope of 8.8 and r = 0.80 for the Access 2, ADVIA Centaur, AxSYM, and E170, respectively. Overall analytic concordance values with the Triage meter were 95.9%, 92.9%, 92.4%, and 84.3% for the Access 2, ADVIA Centaur, AxSYM, and E170, respectively. All automated natriuretic peptide methods showed acceptable analytic performance.

B-type Natriuretic Peptide circulating forms: Analytical and bioactivity issues

“…Similarly, BNP(4-32), had close to 160% cross-reactivity in three immunoassays (Access 2, ADVIA Centaur, and AxSYM), while BNP(1-31) cross-reacted only in the Access 2 immunoassay but not the ADVIA Centaur and AxSYM assays [49,55]. These cross-reactivity patterns reflect the use of inner arm (e.g.…”

“…Little is known about the cross-reactivities of truncated BNP forms in BNP assays apart from BNP , which has close to full cross-reactivity in five different immunoassays [49,54,55]. Similarly, BNP(4-32), had close to 160% cross-reactivity in three immunoassays (Access 2, ADVIA Centaur, and AxSYM), while BNP(1-31) cross-reacted only in the Access 2 immunoassay but not the ADVIA Centaur and AxSYM assays [49,55].…”

B-type Natriuretic Peptide Is a Sensitive Screening Test for Acute Rejection in Pediatric Heart Transplant Patients

“…BNP 31 In addition, the Department of Pathology at Texas Children's Hospital performed additional correlation testing in 19 samples, which revealed a correlation coefficient of 0.998. 32 AR was defined as an International Society for Heart and Lung Transplantation (ISHLT) biopsy score of Grade Ն3A (2R rejection using the 2004 revised grading system) or humoral rejection.…”

The relationship between the level of plasma B-type natriuretic peptide and mitral stenosis

“…ProBNP then is cleaved into BNP, the active hormone, and NT-proBNP, an inactive fragment. However, one of these two biomarkers can be chosen depending on equipment availability [6].…”