N-terminal pro-B-type natriuretic peptide concentrations predict the risk of cardiovascular adverse events from antiinflammatory drugs: A pilot trial

Kay Brune, Hugo A. Katus, Joachim Moecks, Eberhard Spanuth, Allan S. Jaffe, Evangelos Giannitsis

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

BACKGROUND: We investigated whether higher concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) predicts cardiovascular adverse events (CV-AEs) in patients with osteoarthritis treated with antiinflammatory drugs. METHODS: NT-proBNP was measured in baseline samples from 433 patients enrolled in a prospective randomized study designed to test the therapeutic effect of a novel metalloproteinase inhibitor. We monitored CV-AEs and retrospectively investigated their relationship to the concomitant use of selective cyclooxygen-ase-2 inhibitors (coxibs), traditional nonsteroidal antiinflammatory drugs (tNSAIDs), and glucocorticoids. CV-AEs included myocardial infarction, stroke, new or worsening of preexisting arterial hypertension, congestive heart failure, and several less severe CV-AEs. RESULTS: We observed 82 mild to serious CV-AEs during an observational period of 200 days. The risk of such events was 1.95-fold higher in patients who were taking tNSAIDs, glucocorticoids, or coxibs (i.e., any inhibitor) and who had NT-proBNP concentrations ≥ 100 ng/L than in patients taking any inhibitor who had NT-proBNP values < 100 ng/L (P < 0.05). Patients taking coxibs (alone or in addition to tNSAIDs or glucocorticoids) with baseline NT-proBNP values ≥100 ng/L had a 7.41-fold higher risk for CV-AEs than those with baseline values < 100 ng/L (P < 0.01). Patients who were taking 2 or more antiinflammatory drugs and had NT-proBNP values ≥ 100 ng/L had a 3.74-fold higher risk for CV-AEs than those with NT-proBNP values < 100 ng/L (P < 0.05). An NT-proBNP value < 100 ng/L was associated with negative predictive values of >85% across all treatment groups. CONCLUSIONS: NT-proBNP may be a useful marker for anticipating cardiovascular risk associated with the use of antiinflammatory drugs for osteoarthritis.

Original languageEnglish (US)
Pages (from-to)1149-1157
Number of pages9
JournalClinical chemistry
Volume54
Issue number7
DOIs
StatePublished - Jul 1 2008

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ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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