NT-proBNP levels may be influenced by inflammation in active ankylosing spondylitis receiving TNF blockers: a pilot study

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author MORAES, Julio C. B. FMUSP-HC
RIBEIRO, Ana C. M. FMUSP-HC
SAAD, Carla G. S. FMUSP-HC
LIANZA, Alessandro C. FMUSP-HC
SILVA, Clovis A. FMUSP-HC
BONFA, Eloisa FMUSP-HC
dc.date.issued 2013
dc.identifier.citation CLINICAL RHEUMATOLOGY, v.32, n.6, p.879-883, 2013
dc.identifier.issn 0770-3198
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/1707
dc.description.abstract N-terminal pro-brain natriuretic peptide (NT-proBNP) is a strong marker of cardiovascular disease with recent evidence that inflammation may also influence its levels; discrimination of this confounding variable is of particular interest in rheumatic diseases. Therefore, we evaluated NT-proBNP in ankylosing spondylitis (AS) patients pre- and post-TNF blocker to determine the possible association between NT-proBNP levels and inflammatory parameters. Forty-five consecutive AS patients without previous/current cardiovascular disease or systolic myocardial dysfunction, who were eligible to anti-TNF therapy, were prospectively enrolled. All patients received TNF blockers and they were evaluated for circulating NT-proBNP levels, clinical and laboratory parameters of disease activity, traditional cardiovascular risk factors, and conventional and tissue Doppler imaging echocardiography at baseline (BL) and 6 months after (6M) treatment. At BL, all patients had active AS, NT-proBNP levels had a median of 36 (20-72) pg/mL and 11 % were high in spite of no systolic alteration. Multiple linear regression analysis revealed that this peptide, at BL, was independently correlated with erythrocyte sedimentation rate (ESR) (p < 0.001), age (p = 0.01), and pulse pressure (p = 0.01). After 6M, all disease parameters improved and NT-proBNP levels were significantly reduced [24 (16-47) pg/mL, p = 0.037] compared to BL. Changes in NT-proBNP were positively correlated with ESR changes (r = 0.41, p = 0.006). Cardiovascular risk factors remained stable during follow-up. In conclusion, our data suggest that elevations of NT-proBNP should be interpreted with caution in active AS patients with no other evidence of cardiovascular disease. The short-term reduction of NT-proBNP levels in these patients receiving anti-TNF therapy appears to reflect an improvement in inflammatory status.
dc.description.sponsorship · Agency for Promotion of Research
· Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [06/61303-7]
· National Counsel of Technological and Scientific Development [302724/2011-7, 305468/2006-5]
· Federico Foundation
dc.language.iso eng
dc.publisher SPRINGER LONDON LTD
dc.relation.ispartof Clinical Rheumatology
dc.rights restrictedAccess
dc.subject Ankylosing spondylitis; Anti-TNF; Cardiovascular disease; Inflammation; NT-proBNP
dc.subject.other natriuretic peptide levels; rheumatoid-arthritis; disease; risk; mortality; events
dc.title NT-proBNP levels may be influenced by inflammation in active ankylosing spondylitis receiving TNF blockers: a pilot study
dc.type article
dc.rights.holder Copyright SPRINGER LONDON LTD
dc.description.group LIM/17
dc.description.group LIM/36
dc.identifier.doi 10.1007/s10067-013-2182-x
dc.identifier.pmid 23381669
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author MORAES, Julio C. B.:FM:
hcfmusp.author RIBEIRO, Ana C. M.:FM:
hcfmusp.author SAAD, Carla G. S.:FM:
hcfmusp.author LIANZA, Alessandro C.:FM:
hcfmusp.author SILVA, Clovis A.:HC:ICR
hcfmusp.author BONFA, Eloisa:FM:MCM
hcfmusp.origem.id 2-s2.0-84879197991
hcfmusp.origem.id WOS:000320473900020
hcfmusp.publisher.city LONDON
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
hcfmusp.citation.scopus 10
hcfmusp.citation.wos 10


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