Clinical evaluation of capillary B-type natriuretic peptide testing.

Background 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. Methods BNP was measured with a novel single epitope POC assay (Minicare(R) BV, Eindhoven, The Netherlands) and NT-proBNP with a central laboratory assay (Roche Diagnostics(R), Vienna, Austria). Results 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. Conclusions 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.