Back to glossary
Biomarkers

NT-proBNP

Reviewed by

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is the biologically inactive N-terminal fragment cleaved from proBNP when cardiomyocytes are stretched by elevated ventricular wall stress or volume overload. It has a longer half-life (~60–120 minutes) than BNP itself, making it analytically more stable. NT-proBNP is a central diagnostic and prognostic biomarker for heart failure: in non-acute settings, a value above 125 pg/mL is widely used as a rule-out threshold, while 2023 ESC HFA guidance recommends age-stratified rule-in thresholds (125 pg/mL for age <50, 250 pg/mL for 50–74 years, and 500 pg/mL for ≥75 years). Beyond established heart failure, modestly elevated NT-proBNP in community populations is independently associated with atrial fibrillation, coronary artery disease, chronic kidney disease, and all-cause mortality, so it is increasingly used as a subclinical cardiac stress marker in longevity assessments.

Sources

  1. Januzzi JL, Camargo CA, Anwaruddin S, Baggish AL, Chen AA, Krauser DG, et al.. (2005). NT-proBNP testing for diagnosis of congestive heart failure in patients presenting with dyspnea (PRIDE study). *American Journal of Cardiology*doi:10.1016/j.amjcard.2004.08.015
  2. Blankenberg S, Salomaa V, Makarova N, Ojeda F, Wild P, Lackner KJ, et al.. (2016). NT-proBNP as a marker of cardiovascular risk in general population — the BiomarCaRE project. *European Heart Journal*doi:10.1093/eurheartj/ehw169