N-terminal prohormone brain natriuretic peptide: a biomarker for detecting cardiovascular risks in patients with rheumatoid arthritis or osteoarthritis?

Häupl, Thomas; Burmester, Gerd R.; Giannitsis, Evangelos; Rohrlach, Thorsten; Spanuth, Eberhard; Parsch, Hans; Brune, Kay

doi:10.1136/ard.2006.066522

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…Two studies also included echocardiographic assessment and reported that BNP/NT‐proBNP levels were significantly higher in RA subjects with measures indicative of preclinical CVD (8, 10). Several letters suggested that BNP/NT‐proBNP may be useful for screening RA patients for CVD prior to initiating treatment with cyclooxygenase 2 inhibitors (10, 17, 18). In addition, a recent study suggests NT‐proBNP levels decrease in RA patients following initiation of TNFα blockade treatment, and these changes correlated with changes in erythrocyte sedimentation rate (19).…”

Section: Discussionmentioning

confidence: 99%

Use of B‐type natriuretic peptide as a screening tool for left ventricular diastolic dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease

Crowson

Myasoedova

Davis

et al. 2011

Arthritis Care & Research

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Objective. Patients with rheumatoid arthritis (RA) are at an increased risk for heart failure and left ventricular diastolic dysfunction (LVDD). B-type natriuretic peptide (BNP) may be useful to screen for LVDD in the general population. We compared the effectiveness of BNP as a screening tool for LVDD in RA and non-RA subjects without cardiovascular disease (CVD). Methods. Study subjects were recruited from population-based samples with and without RA, excluding subjects with CVD. LVDD was assessed by 2-dimensional and Doppler echocardiography and categorized as none, mild, moderate/ severe, or indeterminate. Linear regression and proportional odds models evaluated the association between LVDD and BNP, adjusting for age, sex, and body mass index. Results. Among 231 RA and 1,730 non-RA subjects without CVD, BNP was significantly higher in subjects with moderate/severe LVDD compared to those with no or mild LVDD (P ‫؍‬ 0.02 for RA and P < 0.001 for non-RA subjects). More RA subjects had elevated BNP than non-RA subjects (16% versus 9%; P < 0.001). Positive predictive value (25% in RA and 18% in non-RA subjects) and sensitivity (40% in RA and 26% in non-RA subjects) were similarly low in both cohorts, but specificity was significantly lower in RA than in non-RA subjects (89% versus 94%; P ‫؍‬ 0.02). Conclusion. While RA subjects were more likely to have elevated BNP, few RA patients with elevated BNP actually have LVDD. Also, normal BNP levels are less likely to rule out LVDD in RA than in non-RA subjects. Therefore, BNP may be less effective for screening in RA subjects compared to the general population.

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Section: Discussionmentioning

confidence: 99%

Use of B‐type natriuretic peptide as a screening tool for left ventricular diastolic dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease

Crowson

Myasoedova

Davis

et al. 2011

Arthritis Care & Research

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“…Left ventricular dysfunction was 3-fold more frequent in rheumatoid arthritis patients than in the general population [29], but with no or aspecific symptoms, often unrecognized. In 309 patients with rheumatoid arthritis or osteoarthritis, NT-proBNP levels were higher than in healthy subjects; however, half of the patients with NT-proBNP elevation had no clear sign of cardiovascular disease (related to chronic heart failure, ischemic heart disease, or arrhythmias) [30].…”

Section: Nt-probnp Natriuretic Peptide As An Early Marker Of Subclinimentioning

confidence: 98%

When the heart is burning: Amino-terminal pro-brain natriuretic peptide as an early marker of cardiac involvement in active autoimmune rheumatic disease

Giannoni¹,

Tani²,

Clerico³

et al. 2011

International Journal of Cardiology

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“…The presence of high levels of anti–Apo A‐I is associated with vulnerable atherosclerotic plaques in humans and in mice (18). In a cross‐sectional study, N‐terminal pro–brain natriuretic peptide (NT‐proBNP) levels were higher in RA than in control patients and were associated with various cardiac disease outcomes (19, 20). Oxidized low‐density lipoprotein (ox‐LDL) is associated with CVD in the general population and is independently associated with subclinical atherosclerosis and disease activity in patients with RA (21–25).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cardiovascular risk in patients with rheumatoid arthritis: Do cardiovascular biomarkers offer added predictive ability over established clinical risk scores?

Finckh

Courvoisier

Pagano

et al. 2012

Arthritis Care & Research

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Objective. To determine whether adding C-reactive protein, anti-cyclic citrullinated peptide antibodies, rheumatoid factor, N-terminal pro-brain natriuretic peptide (NT-proBNP), oxidized low-density lipoprotein (ox-LDL), or antiapolipoprotein A-I (anti-Apo A-I) IgG to the Framingham 10-year cardiovascular (CV) risk score (FRS) could improve its CV prognostic accuracy in rheumatoid arthritis (RA). Methods. We performed an ancillary study derived from a prospective single-center cohort consisting of 118 RA patients without CV disease at baseline. The FRS and the various biomarkers were assessed at enrollment and their prognostic accuracy was determined using receiver operating characteristic (ROC) curve analysis. The incremental predictive ability of biomarkers was assessed using the integrated discrimination improvement (IDI) statistics. Results. During a median followup period of 9 years, the incidence of CV events was 16%. Both the FRS and 3 of the biomarkers (NT-proBNP, ox-LDL, and anti-Apo A-I) were significant predictors of subsequent CV events (area under the ROC curve [AUC] between 0.68 and 0.73). Anti-Apo A-I was the only biomarker to significantly improve the prognostic ability of the FRS, with AUCs increasing from 0.72 to 0.81 and the IDI improving by 175% (P < 0.001).Conclusion. Among the biomarkers tested, only anti-Apo A-I significantly improved the FRS predictive ability.

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N-terminal prohormone brain natriuretic peptide: a biomarker for detecting cardiovascular risks in patients with rheumatoid arthritis or osteoarthritis?

Cited by 9 publications

References 5 publications

Use of B‐type natriuretic peptide as a screening tool for left ventricular diastolic dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease

Use of B‐type natriuretic peptide as a screening tool for left ventricular diastolic dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease

When the heart is burning: Amino-terminal pro-brain natriuretic peptide as an early marker of cardiac involvement in active autoimmune rheumatic disease

Evaluation of cardiovascular risk in patients with rheumatoid arthritis: Do cardiovascular biomarkers offer added predictive ability over established clinical risk scores?

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