Diagnostic utility of total NT-proBNP testing by immunoassay based on antibodies targeting glycosylation-free regions of NT-proBNP
Author:
Li Ling1, Semenov Alexander G.2, Feygina Evgeniya E.2, Yang Chenchen3, Wang Nan3, Chen Chao3, Hu Xinghai4, Ni Xiaoqin4, Zhang Zhenlu1
Affiliation:
1. Wuhan Asia Heart Hospital , Wuhan , P.R. China 2. HyTest group , Turku , Finland 3. HyTest group , Shanghai , P.R. China 4. PerkinElmer , Taicang , P.R. China
Abstract
Abstract
Objectives
The N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) is a widely used heart failure (HF) biomarker. Commercial NT-proBNP immunoassays detect only a subfraction of endogenous NT-proBNP, as the antibodies target a region of NT-proBNP that could be glycosylated at Ser44. The diagnostic utility of immunoassays measuring total NT-proBNP remains unclear.
Methods
NT-proBNP was measured in 183 HF and 200 non-HF patients diagnosed by two independent cardiologists blinded to NT-proBNP results. Plasma samples either non-treated or treated with a mixture of glycosidases were analyzed by the Elecsys proBNP II assay (Roche Diagnostics, based on antibodies targeting a glycosylated region of NT-proBNP) and the SuperFlex NT-proBNP assay (PerkinElmer, based on antibodies targeting regions of NT-proBNP that are free of O-glycans). The diagnostic accuracy of the two assays was analyzed by comparison of ROC curves.
Results
The ROC-AUC for the proBNP II assay was 0.943 (95% CI 0.922–0.964) for NT-proBNP measured in untreated samples and 0.935 (0.913–0.958) for NT-proBNP measured in glycosidase-treated samples. The SuperFlex NT-proBNP assay in untreated samples gave a ROC-AUC of 0.930 (95% CI 0.907–0.954). The median percentage of non-glycosylated NT-proBNP to total NT-proBNP was 1.5–1.6-fold lower in the non-HF group compared to that in the HF group.
Conclusions
The clinical value of total NT-proBNP for HF diagnosis was similar to the subfraction of NT-proBNP that was non-glycosylated at Ser44. The lower percentage of non-glycosylated NT-proBNP to total NT-proBNP in non-HF patients suggests that total NT-proBNP might be more sensitive in individuals without current or prior symptoms of HF.
Publisher
Walter de Gruyter GmbH
Subject
Biochemistry (medical),Clinical Biochemistry,General Medicine
Reference26 articles.
1. Ponikowski, P, Voors, AA, Anker, SD, Bueno, H, Cleland, JG, Coats, AJ, et al.. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2016;18:891–975. https://doi.org/10.1002/ejhf.592. 2. Yancy, CW, Jessup, M, Bozkurt, B, Butler, J, Casey, DEJr., Colvin, MM, et al.. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American college of cardiology/American heart association task Force on clinical practice guidelines and the heart failure society of America. Circulation 2017;136:e137–61. https://doi.org/10.1016/j.jacc.2017.04.025. 3. Kavsak, PA, Lam, CSP, Saenger, AK, Jaffe, AS, Collinson, P, Pulkki, K, et al.. Educational recommendations on selected analytical and clinical aspects of natriuretic peptides with a focus on heart failure: a report from the IFCC committee on clinical applications of cardiac bio-markers. Clin Chem 2019;65:1221–7. https://doi.org/10.1373/clinchem.2019.306621. 4. Seferian, KR, Tamm, NN, Semenov, AG, Tolstaya, AA, Koshkina, EV, Krasnoselsky, MI, et al.. Immunodetection of glycosylated NT-proBNP circulating in human blood. Clin Chem 2008;54:866–73. https://doi.org/10.1373/clinchem.2007.100040. 5. Nishikimi, T, Ikeda, M, Takeda, Y, Ishimitsu, T, Shibasaki, I, Fukuda, H, et al.. The effect of glycosylation on plasma N-terminal proBNP-76 levels in patients with heart or renal failure. Heart 2012;98:152–61. https://doi.org/10.1136/heartjnl-2011-300102.
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