A multimarker approach to diagnose and stratify heart failure

Wan, Yunxia, Xhang, Xi, Atherton, John J., Kostner, Karam, Dimeski, Goce, & Punyadeera, Chamindie (2015) A multimarker approach to diagnose and stratify heart failure. International Journal of Cardiology, 181, pp. 369-375.

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We have previously demonstrated that circulating NT-proBNP is truncated at the N and C termini. Aims of this study are three-fold: firstly to determine whether the NT-proBNP levels correlate with NYHA functional classes when measuring with different antibody pairs; secondly to evaluate the diagnostic potential of ProBNP and; thirdly to investigate whether combining NT-proBNP assays with or without ProBNP would lead to better diagnostic accuracies.


Plasma samples were collected from healthy controls (n = 52) and HF patients (n = 46). Customized AlphaLISA® immunoassays were developed and validated to measure the concentrations of proBNP and NT-proBNP (with antibodies targeting 13–45, 13–76, 28–76). The diagnostic performance and predictive value of proBNP and NT-proBNP assays and their combinations were evaluated.


Plasma proBNP assay showed acceptable diagnostic performance. NT-proBNP13–76 assay is useful in diagnosing and stratifying HF patients. The diagnostic performance of NT-proBNP13–76 demonstrated improvement over commercial NT-proBNP tests. The combination of NT-proBNP13–76 with NT-proBNP28–76 assays gave the best diagnostic assay performance.


Our results demonstrate that while there is major heterogeneity in circulating NT-proBNP, specific epitopes of the peptides are extraordinarily stable, providing ideal targets for clinically useful diagnostic assays. Future new clinical diagnostic clinical trials should include a multimarker approach rather than using a single marker to diagnose HF.

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ID Code: 87974
Item Type: Journal Article
Refereed: Yes
Keywords: heart failure, saliva, multimarker, diagnostics, monitoring
DOI: 10.1016/j.ijcard.2014.12.052
ISSN: 0167-5273
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2015 Elsevier
Deposited On: 02 Oct 2015 02:47
Last Modified: 05 Oct 2015 23:30

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