Amino-Terminal Pro–B-Type Natriuretic Peptides: Testing in General Populations

Screening of general populations with amino-terminal pro–B-type natriuretic peptides (NT-proBNP) holds promise for the detection of significant underlying cardiac structural and functional abnormalities, as well as for the early detection of the propensity to develop future cardiovascular events. In comparative studies to date, NT-proBNP performs at least as well as BNP in the detection of heart disease and prognostication in the general population. In some studies and subgroups, NT-proBNP appears to outperform BNP in population screening. More needs to be learned about noncardiac sources of NT-proBNP variation in “apparently well” populations. Better understanding of these factors may allow optimization of thresholds for screening of apparently well patients and concomitant delineation of patient populations in whom NT-proBNP screening is less appropriate.