Heart failure & cardiomyopathies
A Novel N-Terminal Pro-B-Type Natriuretic Peptide Assay in the Early Diagnosis of Acute Heart Failure
Authors' conclusion
The NT-proBNP-Access assay had a very high diagnostic accuracy for AHF. Levels were approximately 25% higher with NT-proBNP-Access vs NT-proBNP-Elecsys, resulting in minor diagnostic discordance in 1 of 7 patients using guideline-recommended decision values.
Study context
- Population
- Patients presenting with acute dyspnoea to the ED53% acute HF
- Participants
- 1,400 patients
- Comparison
- NT-proBNP-Access vs NT-proBNP-Elecsys assay
- Outcome
- Diagnostic accuracy for acute HF (AUC)
Methodological detailsprospective, multicentre, blinded measurement
- Prospective
- Multicentre
- Blinded measurement
Performance
As reported in the abstract
Diagnostic accuracy for acute HF
| Test or model | AUC |
|---|---|
| NT-proBNP-Access | 0.914 (95% CI: 0.898-0.93) |
| NT-proBNP-Elecsys | 0.922 (95% CI: 0.908-0.937) |
AUC
NT-proBNP-Access0.914 (95% CI: 0.898-0.93)
NT-proBNP-Elecsys0.922 (95% CI: 0.908-0.937)
- NT-proBNP-Access vs NT-proBNP-Elecsys: P = 0.006 — slightly lower with Access
Secondary outcomes
NT-proBNP concentration · higher with Access
P < 0.001
Guideline decision values (rule-out <300 pg/mL; rule-in age-adjusted >450/900/1,800 pg/mL) · 77.6% vs 84.8%
P < 0.001
Ruled out
Sensitivity
Ruled in
Specificity
Diagnostic concordance between assays
- Concordance
- 85.3%
- Major mismatch (no acute heart failure (AHF) vs AHF)
- 0.6%
- Minor mismatch (gray zone vs rule in/rule out)
- 14.1%
Original publication
A Novel N-Terminal Pro-B-Type Natriuretic Peptide Assay in the Early Diagnosis of Acute Heart Failure. JACC Adv. Published 29 September 2025. doi:10.
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