Dr James L Januzzi
Cardiologist, Massachusetts General Hospital. Prof of Medicine, Harvard Medical School

Reference ranges for NT-proBNP & hs-TnT in Asian populations


  • The North South East West study with more than 1000 patients compared the Asian population with the Western population for the reference range of NT-proBNP and hs-TnT. Results show that Asian patients can be evaluated with the same reference values as the Western patient population without concerns of misdiagnosis.

The North South East West study was an analysis that we designed to ask the question as to whether concentrations of NT-proBNP and highly sensitive Troponin T, another cardiac biomarker, could be measured with the same reference ranges in patients here in Vietnam versus Western populations.

The North South East West study looked at 4 centres: 2 in the North, 2 in the South. In Vietnam, it was in Hanoi and in Ho Chi Minh City. In the United States, it was Boston and Baltimore. And then – East and West of course is Vietnam and the United States. We enrolled over a thousand patients – 500 or more in each of the different countries and analysed for NT-proBNP and highly sensitive Troponin T.

What we found from the North South East West study was that, while there were substantial differences in the baseline demographics and medical conditions between patients enrolled in Vietnam versus the United States, remarkably, we found very few, if any, substantial differences in the biomarkers that we measured.

What this suggests is, in fact, that patients in Vietnam can be evaluated with the same reference limits that are used from Western populations, without concerns about misdiagnosis using those cut-offs.

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