Brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP) and N-terminal ANP are good research indices of the severity of heart failure. The stability of these peptides at room temperature has become an important factor in assessing their use as indicators of cardiac function in routine clinical practice. Inhibitors such as aprotinin are routinely added in the blood collection process, but may provide no benefit in sample collection and routine clinical practice. We assessed the stability of BNP, ANP and N-terminal ANP in blood samples collected in either the presence or the absence of the protease inhibitor aprotinin. Blood, either with or without aprotinin, was processed immediately (initial; 0 h) and after blood samples had been left for 3 h, 2 days or 3 days at room temperature. These times were chosen to reflect processing in a hospital outpatient clinic (2–3 h), or when posted from general practice (2–3 days). Initial plasma BNP, ANP and N-terminal ANP levels in the absence of aprotinin were 28.2±5.4, 44.2±7.9 and 1997±608 pg/ml respectively, and were not significantly different from initial values in the presence of aprotinin (29.0±5.9, 45.2±8.0 and 2009±579 pg/ml respectively). After 3 h at room temperature, there was a significant fall in ANP in the absence of aprotinin (36.7±7.9 pg/ml; P< 0.005), but not in the presence of aprotinin (41.2±7.6 pg/ml). Both BNP and N-terminal ANP were unchanged in either the absence (BNP, 27.6±5.5 pg/ml; N-terminal ANP, 2099±613 pg/ml) or the presence (BNP, 29.4±5.6 pg/ml; N-terminal ANP, 1988±600 pg/ml) of aprotinin. After 2 days at room temperature, ANP had fallen significantly in both the absence (16.9±3.4 pg/ml) and the presence (24.0±5.0 pg/ml) of aprotinin compared with initial values, and there was a significant difference in ANP levels in the absence and presence of aprotinin (P< 0.001). ANP levels had decreased further after 3 days at room temperature, to 11.9±3.4 pg/ml (no aprotinin) and 20.3±5.0 pg/ml (aprotinin added); these values were significantly different (P = 0.002). In contrast, there was no change in the levels of BNP or N-terminal ANP after 2 or 3 days at room temperature, in either the absence or the presence of aprotinin. These studies indicate that aprotinin adds little benefit to the stability of cardiac peptides at room temperature. Blood samples for BNP and N-terminal ANP measurement used as a test of heart function in hospital clinics and by general practitioners in the community could be taken into blood tubes containing only EDTA as anticoagulant and without the additional step of adding the routinely used inhibitor aprotinin.
Skip Nav Destination
Article navigation
Research Article|
November 15 1999
Cardiac peptide stability, aprotinin and room temperature: importance for assessing cardiac function in clinical practice
Martin G. BUCKLEY;
1Heart Science Centre, National Heart & Lung Institute, Imperial College School of Medicine, Harefield, Middlesex UB9 6JH, U.K.
Correspondence: Dr M. G. Buckley.
Search for other works by this author on:
Neil J. MARCUS;
Neil J. MARCUS
1Heart Science Centre, National Heart & Lung Institute, Imperial College School of Medicine, Harefield, Middlesex UB9 6JH, U.K.
Search for other works by this author on:
Magdi H. YACOUB
Magdi H. YACOUB
1Heart Science Centre, National Heart & Lung Institute, Imperial College School of Medicine, Harefield, Middlesex UB9 6JH, U.K.
Search for other works by this author on:
Publisher: Portland Press Ltd
Received:
June 11 1999
Revision Received:
August 06 1999
Accepted:
September 03 1999
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 1999
1999
Clin Sci (Lond) (1999) 97 (6): 689–695.
Article history
Received:
June 11 1999
Revision Received:
August 06 1999
Accepted:
September 03 1999
Citation
Martin G. BUCKLEY, Neil J. MARCUS, Magdi H. YACOUB; Cardiac peptide stability, aprotinin and room temperature: importance for assessing cardiac function in clinical practice. Clin Sci (Lond) 1 December 1999; 97 (6): 689–695. doi: https://doi.org/10.1042/cs0970689
Download citation file:
Sign in
Don't already have an account? Register
Sign in to your personal account
You could not be signed in. Please check your email address / username and password and try again.
Could not validate captcha. Please try again.
Biochemical Society Member Sign in
Sign InSign in via your Institution
Sign in via your InstitutionGet Access To This Article
Cited By
Open Access for all
We offer compliant routes for all authors from 2025. With library support, there will be no author nor reader charges in 5 journals. Check here |
![]() |