SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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G PRINTZEN1 , E BECK1 , R KRIEGER1

1IKC, INSELSPITAL, BERN, SWITZERLAND

OBJECTIVE:
To investigate the influence of sample type (heparin, serum, EDTA-blood) and temperature [room-temperature(RT) and refrigerator (RF,6 Centigrade Celsius)] on the stability of natriuretic peptides (NP; e.g. B-type Natriuretic Peptide (BNP) and NT-proBNP).
METHODS:
312 consecutive samples from patients of our daily routine were analysed. EDTA-plasma-, serum-, and Li-Heparin-plasma-samples were aliquoted for stability-analysis at RT (22 Celsius) and RF (6 Celsius). Aliquoted samples were determined (single) at time points 0, 3, 6, and 24 hours. BNP was measured with two commercial methods on AxSYM and TriageMeter(Abbott and Biosite) and NT-proBNP on Elecsys 2010 (Roche).
RESULTS:
Concentrations of natriuretic peptides - BNP as well as NT-proBNP - decreased over the time studied. 24 hour-values were approximately 15-20% lower in the recommended type of sample. Stability of BNP was differently affected by the use of different matrices (e.g. serum, heparin-plasma, and EDTA-plasma); discrepancies up to 50% could be determined after 24 hours. Temperature did not significantly influence the concentrations of the NP.
CONCLUSION:
From our point of view a 15-20% (and less) reduction of concentration in 24hour-samples seems to be quite acceptable. But especially BNP should be determined only in EDTA-samples - as recommended by the manufactures. Influences of other matrices (e.g. serum, heparin-plasma) on BNP lead to non reproducible differences of its concentration, whereas NT-proBNP passed the determination in these sample-types (decrease comparable to EDTA-plasma: 15-20% within 24hours). Our study underlines that the stability of natriuretic peptides at room temperature is absolutely sufficient for beeing used as express sample by sending it through the post. If by any chance express delivery might not be available we recommend to send the samples frozen.

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