BNP Elevation Risk Tier (Cardiotoxicity Marker): Explanation and Clinical Context B-type Natriuretic Peptide (BNP) is a cardiac neurohormone released in response to ventricular volume expansion and pressure overload. Elevated BNP levels in patients undergoing potentially cardiotoxic therapies, such as anthracyclines or trastuzumab, may indicate early myocardial stress and subclinical cardiotoxicity.
BNP risk stratification helps clinicians identify patients at low, moderate, or high risk for developing clinically significant cardiotoxicity. Low risk corresponds to BNP <100 pg/mL, moderate risk for BNP 100–399 pg/mL, and high risk for BNP >400 pg/mL. This stratification guides monitoring frequency, early intervention, and referral to cardiology when necessary.
Reference:
Sawaya H, et al. Early Detection and Prediction of Cardiotoxicity in Patients Receiving Anthracyclines Using Cardiac Biomarkers and Echocardiography. J Am Coll Cardiol. 2011;57(3): 271-278. doi:10.1016/j.jacc.2010.08.037