N-terminal pro–B-type natriuretic peptide (NT-proBNP) (NT-proBNP)

N-terminal pro–B-type natriuretic peptide (NT-proBNP) is a 76-amino acid, biologically inactive peptide fragment produced by the cleavage of the precursor molecule proBNP. This cleavage occurs in response to increased myocardial wall stress and volume overload, releasing both the active hormone B-type natriuretic peptide (BNP) and the stable NT-proBNP fragment into the circulation in a 1:1 stoichiometric ratio (StatPearls, NBK556136). Unlike BNP, NT-proBNP has a longer half-life (approximately 70-120 minutes) and higher circulating concentrations, making it a highly sensitive biomarker for the diagnosis and risk stratification of heart failure (PubMed, 15607383). While it is not a direct therapeutic target for drugs, its levels are critically monitored to assess the efficacy of cardiovascular treatments, such as neprilysin inhibitors. Because NT-proBNP is not a substrate for neprilysin, it remains a reliable marker for monitoring heart failure in patients treated with sacubitril/valsartan, whereas BNP levels may be artificially elevated by the drug (NIH, PMC5447150). Clinical interpretation of NT-proBNP must account for renal function, as it is primarily cleared by the kidneys, and levels can be significantly elevated in patients with chronic kidney disease.

Other names

NT-proBNPN-terminal pro-brain natriuretic peptideBNP precursor fragmentN-terminal pro-B-type natriuretic peptide

Not applicable as NT-proBNP is a biologically inactive cleavage product used primarily as a diagnostic and prognostic biomarker rather than a therapeutic target.