BNP/Troponin Dual Elevation Index: Explanation and Clinical Context The BNP/Troponin Dual Elevation Index is a simple clinical tool designed to stratify risk in patients with acute heart failure or suspected acute coronary syndrome by evaluating simultaneous elevations of B-type Natriuretic Peptide (BNP) and cardiac troponin.
Elevated BNP (>400 pg/mL) reflects myocardial stretch and volume overload, while elevated troponin (>14 ng/L) indicates myocardial injury. The index assigns 1 point for each biomarker above its respective threshold, resulting in a total score of 0–2.
A score of 0 indicates low risk, 1 indicates intermediate risk, and 2 indicates high risk of adverse outcomes, including mortality and hospitalization.
This tool aids clinicians in early risk stratification, guiding therapeutic intensity and monitoring strategies.
Reference:
Maisel AS, et al. “Combined B-type Natriuretic Peptide and Troponin Elevation in Acute Heart Failure: Risk Stratification and Prognostic Implications.” J Am Coll Cardiol. 2008;52(9):750–756. doi:10.1016/j.jacc.2008.05.024