N-terminal pro-brain natriuretic peptide is a biomarker for cardiovascular damage in systemic lupus erythematous: a cross-sectional study

医学 生物标志物 系统性狼疮 利钠肽 N-末端脑利钠肽前体 脑利钠肽 全身性疾病 横断面研究 内科学 心脏病学 心力衰竭 病理 免疫病理学 疾病 生物化学 化学
作者
Karim Sacré,Évelyne Vinet,Christian A. Pineau,Arielle Mendel,Fares Kalache,Louis-Pierre Grenier,Thao Huynh,Sasha Bernatsky
出处
期刊:Rheumatology [Oxford University Press]
卷期号:63 (6): 1739-1745 被引量:2
标识
DOI:10.1093/rheumatology/kead522
摘要

Abstract Objectives Prediction models based on traditional risk factors underestimate cardiovascular (CV) risk in systemic lupus erythematosus (SLE). In a large sample of unselected SLE patients, we investigated cross-sectional associations of NT-proBNP with cardiovascular damage (CVD). Methods Serum NT-proBNP was measured in SLE patients enrolled in the MUHC Lupus Clinic registry. Serum was collected between March 2022 and April 2023 at annual research visits. The primary outcome was CVD identified on the SLICC Damage Index. Factors associated with CVD and NT-proBNP levels were determined. Results Overall, 270 SLE patients [female 91%, median age 50.7 (first quartile to third quartile: 39.6–62.1) years] were analysed for the primary outcome. Among them, 33 (12%) had CVD. The ROC curve for NT-proBNP demonstrated strong associations with CVD (AUC 0.78, 95% CI 0.69–0.87) with a threshold of 133 pg/ml providing the best discrimination for those with/without CVD. Hypertension (OR 3.3, 95% CI 1.2–9.0), dyslipidaemia (OR 3.6, 95% CI 1.3–9.6) and NT-proBNP >133 pg/ml (OR 7.0, 95% CI, 2.6–19.1) were associated with CVD in the multivariable logistic regression model. Increased NT-proBNP levels were associated with age (OR 4.2, 95% CI 2.2–8.3), ever smoking (OR 1.9, 95% CI 1.0–3.5), reduced eGFR (4.1, 95% CI 1.3–13.1), prior pericarditis/pleuritis (OR 2.5, 95% CI 1.4–4.5) and aPL antibodies (OR 2.6, 95% CI 1.4–4.9). Conclusion NT-proBNP is a biomarker for CV damage in SLE. The novel associations of NT-proBNP levels with prior pericarditis/pleuritis and aPL antibodies suggest new avenues for research to better understand what drives CV risk in SLE.
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