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Prognostic value of N-terminal natriuretic peptides in systemic sclerosis: a single centre study.
Clin Exp Rheumatol. 2014 Nov-Dec; 32(6 Suppl 86):S-75-81.CE

Abstract

OBJECTIVES

Cardiac involvement is an important determinant of prognosis in systemic sclerosis (SSc). The identification of patients with high risk is of great importance. Our aim was to investigate the diagnostic and prognostic value of circulating concentrations of N-terminal fragments of A- and B-type natriuretic peptides (NT-proANP and NT-proBNP) in patients with SSc.

METHODS

We prospectively studied 144 patients with SSc and followed them up for five years. Blood was collected for natriuretic peptide measurement at the time of the yearly scheduled cardiological check-up. The occurrence of clinically significant cardiac disease was measured as the composite of pulmonary arterial hypertension, cardiac revascularisation, development of left ventricular dysfunction or death.

RESULTS

Patients diagnosed with heart involvement during the study had significantly higher levels of NT-proANP and NT-proBNP (791.4 ± 379.9 pmol/l vs. 608.0 ± 375.8 pmol/l, p<0.05 and 183.1 ± 162.6 vs. 125.7 ± 117.5 pmol/l, p<0.05, respectively). Receiver-operator-characteristic analysis identified <822.5 pmol/l as the best NT-proANP and <154.5 pmol/l as the best NT-proBNP threshold (sensitivity 56.3%, specificity 79.5%, negative predictive value: 86.4% and sensitivity 50.0%, specificity 76.8%, negative predictive value: 83.7%, respectively). During the follow-up, lower NT-proANP levels were significantly associated with a longer event-free survival (p<0.05), similar but a non-significant trend regarding NT-proBNP levels was also shown (p=0.052).

CONCLUSIONS

In our cohort, NT-proANP had a supplementary prognostic value for cardiac involvement in systemic sclerosis. In addition, the high negative predictive value of natriuretic peptides supports the more extensive use in identifying SSc patients with high risk of future cardiac involvement.

Authors+Show Affiliations

Kaposi Mór Teaching Hospital, Somogy County, Kaposvar, Hungary. koltogyongyver@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25372791

Citation

Költő, G, et al. "Prognostic Value of N-terminal Natriuretic Peptides in Systemic Sclerosis: a Single Centre Study." Clinical and Experimental Rheumatology, vol. 32, no. 6 Suppl 86, 2014, pp. S-75-81.
Költő G, Vuolteenaho O, Szokodi I, et al. Prognostic value of N-terminal natriuretic peptides in systemic sclerosis: a single centre study. Clin Exp Rheumatol. 2014;32(6 Suppl 86):S-75-81.
Költő, G., Vuolteenaho, O., Szokodi, I., Faludi, R., Tornyos, A., Ruskoaho, H., Minier, T., Czirják, L., & Komócsi, A. (2014). Prognostic value of N-terminal natriuretic peptides in systemic sclerosis: a single centre study. Clinical and Experimental Rheumatology, 32(6 Suppl 86), S-75-81.
Költő G, et al. Prognostic Value of N-terminal Natriuretic Peptides in Systemic Sclerosis: a Single Centre Study. Clin Exp Rheumatol. 2014 Nov-Dec;32(6 Suppl 86):S-75-81. PubMed PMID: 25372791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of N-terminal natriuretic peptides in systemic sclerosis: a single centre study. AU - Költő,G, AU - Vuolteenaho,O, AU - Szokodi,I, AU - Faludi,R, AU - Tornyos,A, AU - Ruskoaho,H, AU - Minier,T, AU - Czirják,L, AU - Komócsi,A, Y1 - 2014/11/03/ PY - 2014/01/21/received PY - 2014/03/19/accepted PY - 2014/11/6/entrez PY - 2014/11/6/pubmed PY - 2015/10/31/medline SP - S-75-81 JF - Clinical and experimental rheumatology JO - Clin Exp Rheumatol VL - 32 IS - 6 Suppl 86 N2 - OBJECTIVES: Cardiac involvement is an important determinant of prognosis in systemic sclerosis (SSc). The identification of patients with high risk is of great importance. Our aim was to investigate the diagnostic and prognostic value of circulating concentrations of N-terminal fragments of A- and B-type natriuretic peptides (NT-proANP and NT-proBNP) in patients with SSc. METHODS: We prospectively studied 144 patients with SSc and followed them up for five years. Blood was collected for natriuretic peptide measurement at the time of the yearly scheduled cardiological check-up. The occurrence of clinically significant cardiac disease was measured as the composite of pulmonary arterial hypertension, cardiac revascularisation, development of left ventricular dysfunction or death. RESULTS: Patients diagnosed with heart involvement during the study had significantly higher levels of NT-proANP and NT-proBNP (791.4 ± 379.9 pmol/l vs. 608.0 ± 375.8 pmol/l, p<0.05 and 183.1 ± 162.6 vs. 125.7 ± 117.5 pmol/l, p<0.05, respectively). Receiver-operator-characteristic analysis identified <822.5 pmol/l as the best NT-proANP and <154.5 pmol/l as the best NT-proBNP threshold (sensitivity 56.3%, specificity 79.5%, negative predictive value: 86.4% and sensitivity 50.0%, specificity 76.8%, negative predictive value: 83.7%, respectively). During the follow-up, lower NT-proANP levels were significantly associated with a longer event-free survival (p<0.05), similar but a non-significant trend regarding NT-proBNP levels was also shown (p=0.052). CONCLUSIONS: In our cohort, NT-proANP had a supplementary prognostic value for cardiac involvement in systemic sclerosis. In addition, the high negative predictive value of natriuretic peptides supports the more extensive use in identifying SSc patients with high risk of future cardiac involvement. SN - 0392-856X UR - https://www.unboundmedicine.com/medline/citation/25372791/Prognostic_value_of_N_terminal_natriuretic_peptides_in_systemic_sclerosis:_a_single_centre_study_ L2 - http://www.clinexprheumatol.org/pubmed/find-pii.asp?pii=25372791 DB - PRIME DP - Unbound Medicine ER -