N-terminal-proB-type natriuretic peptide predicts cardiovascular disease events in HIV-infected patients.
BACKGROUND
Cardiovascular disease (CVD) is increasing in HIV-infected patients. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a significant predictor of CVD in the general population. We aimed to quantify the risk of CVD events associated with NT-proBNP at baseline in the Strategies for Management of Anti-Retroviral Therapy study.


METHODS
In a nested case-control study, NT-proBNP was measured at baseline in 186 patients who experienced a CVD event over an average of 2.8 years of follow-up and in 329 matched controls. Odds ratios (ORs) associated with baseline levels of NT-proBNP for CVD were estimated using conditional logistic regression.


RESULTS
At baseline median NT-proBNP [interquartile range (IQR)] was 48.1 (18.5, 112.9) pg/ml in patients who developed a CVD event and 25.7 (12.4, 50.2) pg/ml in controls. The unadjusted OR for the highest versus the lowest quartile was 3.7 [95% confidence interval (CI) 2.1-6.5, P < 0.0001]. After adjustment for baseline covariates and CVD risk factors, OR was 2.8 (95% CI 1.4-5.6, P = 0.003); with additional adjustment for IL-6, high-sensitivity C-reactive protein and D-dimer, OR was 2.3 (95% CI 1.1-4.9, P = 0.02).


CONCLUSIONS
Higher levels of NT-proBNP are associated with increased risk of CVD in HIV patients after considering established CVD risk factors and markers for inflammation and thrombosis.
Cardiovascular Division, University of Minnesota, Minneapolis, 55455, USA. dupre007@umn.edu
Daniel A
DA
Duprez
Jacqueline
J
Neuhaus
Russell
R
Tracy
Lewis H
LH
Kuller
Steven G
SG
Deeks
Chloe
C
Orkin
Albrecht
A
Stoehr
Ian J
IJ
Woolley
James D
JD
Neaton
D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications / Q000378:metabolism*; D016022:Case-Control Studies; D003401:Creatine / Q000378:metabolism*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000378:metabolism*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003401:Creatine
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