High circulating N-terminal pro-brain natriuretic peptide and tumor necrosis factor-alpha in mixed cryoglobulinemia.
OBJECTIVE
To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor alpha (TNF-alpha) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).


METHODS
Serum NTproBNP and TNF-alpha levels were assayed in 50 patients with MC+HCV, and in 50 sex- and age-matched controls.


RESULTS
Cryoglobulinemic patients showed significantly higher mean NTproBNP and TNF-alpha levels than controls (P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (c2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (c2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as the patients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (c2, P = 0.08).


CONCLUSIONS
The study demonstrates high levels of circulating NTproBNP and TNF-alpha in MC+HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.
Department of Internal Medicine, University of Pisa, School of Medicine, Pisa, 56100 Italy. a.antonelli@med.unipi.it
Alessandro
A
Antonelli
Clodoveo
C
Ferri
Silvia-Martina
SM
Ferrari
Fabio
F
Galetta
Ferdinando
F
Franzoni
Gino
G
Santoro
Salvatore
S
De Marco
Emiliano
E
Ghiri
Poupak
P
Fallahi
D000305:Adrenal Cortex Hormones / Q000378:metabolism; D000368:Aged; D016022:Case-Control Studies; D003449:Cryoglobulinemia / Q000097:blood*; D005260:Female; D006333:Heart Failure; D006801:Humans; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
D000305:Adrenal Cortex Hormones; D010446:Peptide Fragments; D014409:Tumor Necrosis Factor-alpha; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain