BNP vs NT-proBNP Differences — EECC MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: A — NT-proBNP has a longer half-life than BNP and is more affected by renal impairment; BNP levels are reduced by sacubitril/valsartan inhibition of neprilysin, while NT-proBNP is not
BNP and NT-proBNP are released in equimolar amounts from myocardial wall stress-induced cleavage of proBNP. Key differences: (1) Half-life: BNP ~20 minutes, NT-proBNP ~120 minutes (NT-proBNP is more stable for sampling); (2) Renal clearance: NT-proBNP is more dependent on renal clearance, so levels are disproportionately elevated in CKD; (3) Neprilysin: BNP is a substrate for neprilysin, so sacubitril/valsartan increases BNP levels (by inhibiting its degradation), making BNP unreliable for monitoring HF in patients on ARNI. NT-proBNP is NOT degraded by neprilysin and should be used for monitoring in patients on sacubitril/valsartan. Diagnostic thresholds differ: BNP >100 pg/mL, NT-proBNP >125 pg/mL (chronic) or >300 pg/mL (acute).
Reference: ESC (2023): HF Guidelines