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Clinical Chemistry 51: 486-493, 2005; 10.1373/clinchem.2004.044594
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(Clinical Chemistry. 2005;51:486-493.)
© 2005 American Association for Clinical Chemistry, Inc.


Special Report

Quality Specifications for B-Type Natriuretic Peptide Assays

Fred S. Apple1,a, Mauro Panteghini2, Jan Ravkilde3, Johannes Mair4, Alan H.B. Wu5, Jillian Tate6, Franca Pagani2, Robert H. Christenson7 and Allan S. Jaffe8 on Behalf of the Committee on Standardization of Markers of Cardiac Damage of the IFCC

1 Department of Laboratory Medicine and Pathology, Hennepin County Medical Center, Minneapolis, MN.
2 Laboratorio Analisi Chimico Cliniche 1, Azienda Ospedaliera Spedali Civili, Brescia, Italy.
3 Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark.
4 Clinical Division of Cardiology, Medical University Innsbruck, Innsbruck, Austria.
5 Department of Laboratory Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA.
6 Department of Chemical Pathology, Queensland Health Pathology Service, Princess Alexandra Hospital, Brisbane, Australia.
7 Department of Pathology, University of Maryland, Baltimore, MD.
8 Department of Laboratory Medicine and Cardiology, Mayo Clinic, Rochester, MN.

aAddress correspondence to this author at: Hennepin County Medical Center, Clinical Laboratories P4, 701 Park Ave., Minneapolis, MN 55415. Fax 612-904-4229; e-mail fred.apple{at}co.hennepin.mn.us.

Background: The objective of this report is to improve the quality of immunochemical measurements of B-type natriuretic peptide (BNP) and its N-terminal propeptide (NT-proBNP). The recommendations proposed are intended for use by manufacturers of commercial assays, by clinical laboratories using those assays, by clinical trial groups and research investigators, and by regulatory agencies, such as the United States Food and Drug Administration.

Methods: A group of cardiac biomarker experts reviewed and abstracted the scientific literature to provide recommendations pertaining to the quality specifications for BNP/NT-proBNP assays.

Results: The evidence-based recommendations encourage manufacturers to endorse and consistently follow the proposed recommendations; encourage that all package inserts for BNP/NT-proBNP immunoassays include uniform information on assay design, preanalytical performance characteristics, analytical performance characteristics, and clinical performance; and encourage regulatory agencies to adopt a minimal and uniform set of criteria for manufacturers to provide when seeking clearance for new and/or improved assays.

Conclusions: These recommendations address the use of BNP and NT-proBNP as cardiac biomarkers and not their physiologic and/or pathophysiologic relevance.




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