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Sendaway capillary NT-proBNP in pulmonary hypertension.
Harrison D Stubbs1,2, John Cannon3, Emily Knightbridge3
1Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Glasgow, UK harrison.stubbs@ggc.scot.nhs.uk.
Sendaway NT-proBNP tests show potential for remote pulmonary hypertension monitoring. While capillary samples at 3 days had some issues, both capillary and venous sendaway tests largely maintained accurate patient risk stratification.
Area of Science:
- Cardiology
- Biomarker analysis
- Remote patient monitoring
Background:
- N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a key biomarker for cardiac ventricular wall stress.
- NT-proBNP is integral to pulmonary hypertension (PH) risk stratification.
- Sendaway sampling offers potential for remote NT-proBNP testing.
Purpose of the Study:
- To evaluate the agreement between sendaway NT-proBNP tests and standard venous NT-proBNP measurements.
- To assess the impact of delayed processing on sendaway NT-proBNP results.
- To determine the utility of remote NT-proBNP testing in PH management.
Main Methods:
- Contemporaneous collection of venous and capillary samples for sendaway NT-proBNP testing.
- Samples were mailed and processed at 3 and 7 days post-collection.
- Analysis included Passing-Bablok regression and percentage difference plots.
Main Results:
- Day 3 capillary samples had a 13% insufficiency rate and were not equivalent to reference samples.
- Day 3 capillary NT-proBNP accurately risk stratified 93.5% of patients.
- Day 3 venous sendaway results were equivalent to reference samples and risk stratified 90.1% of patients.
- Delayed processing (7 days) led to unacceptable agreement and underestimation of NT-proBNP.
Conclusions:
- Sendaway NT-proBNP sampling can serve as an objective measure of right ventricular strain for virtual PH clinics.
- Caution is advised when interpreting results from delayed sendaway NT-proBNP samples.
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