BNP/NT-proBNP Cutoffs Stratified for PH (Calculator)
- Value Enter numeric value in ng/L (e.g., 275 or 275.5).
- Risk Model
- BNP/NT-proBNP Cutoffs in Pulmonary Hypertension: Explanation and Clinical Context
Brain natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) are key biomarkers of right ventricular strain and adverse prognosis in pulmonary arterial hypertension (PAH). Contemporary risk assessment frameworks use peptide thresholds alongside clinical (WHO functional class), exercise (6-minute walk distance), imaging, and hemodynamic data to estimate 1-year mortality risk and to guide therapy escalation.
The ESC/ERS 2022 guideline three-strata approach defines low risk when BNP is <50 ng/L or NT-proBNP is <300 ng/L; intermediate risk at BNP 50–800 ng/L or NT-proBNP 300–1100 ng/L; and high risk when BNP >800 ng/L or NT-proBNP >1100 ng/L.
The COMPERA 2.0 model refines peptide cutoffs into four strata: for BNP <50 (low), 50–199 (intermediate-low), 200–800 (intermediate-high), >800 ng/L (high); and for NT-proBNP <300 (low), 300–649 (intermediate-low), 650–1100 (intermediate-high), >1100 ng/L (high). In COMPERA registry analyses, this four-strata scheme better separated long-term survival—particularly distinguishing intermediate-low from intermediate-high risk—and aligned more closely with clinically meaningful changes between visits.
In practice, values in the intermediate-high or high ranges should prompt reassessment of therapy and closer follow-up, whereas achieving or maintaining low values supports a favorable risk profile when corroborated by other parameters.
Reference:
Humbert M, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2023;61:2200879.
Hoeper MM, et al. COMPERA 2.0: a refined four-stratum risk assessment model for pulmonary arterial hypertension. Eur Respir J. 2022;60:2102311.
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