A multimarker approach to diagnose and stratify heart failure

Wan, Yunxia, Xhang, Xi, Atherton, John J., Kostner, Karam, Dimeski, Goce and Punyadeera, Chamindie (2015) A multimarker approach to diagnose and stratify heart failure. International Journal of Cardiology, 181 369-375. doi:10.1016/j.ijcard.2014.12.052

Author Wan, Yunxia
Xhang, Xi
Atherton, John J.
Kostner, Karam
Dimeski, Goce
Punyadeera, Chamindie
Title A multimarker approach to diagnose and stratify heart failure
Journal name International Journal of Cardiology   Check publisher's open access policy
ISSN 0167-5273
Publication date 2015-02-15
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.ijcard.2014.12.052
Volume 181
Start page 369
End page 375
Total pages 7
Place of publication Shannon, Clare, Ireland
Publisher Elsevier Ireland
Language eng
Formatted abstract

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.
Keyword NT-proBNP
Classify heart failure
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 23 Dec 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
UQ Diamantina Institute Publications
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Created: Wed, 25 Mar 2015, 00:03:31 EST by Kylie Hengst on behalf of UQ Diamantina Institute