TY - JOUR
T1 - N-terminal pro-B-type natriuretic peptide concentrations predict the risk of cardiovascular adverse events from antiinflammatory drugs
T2 - A pilot trial
AU - Brune, Kay
AU - Katus, Hugo A.
AU - Moecks, Joachim
AU - Spanuth, Eberhard
AU - Jaffe, Allan S.
AU - Giannitsis, Evangelos
PY - 2008/7/1
Y1 - 2008/7/1
N2 - 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.
AB - 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.
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U2 - 10.1373/clinchem.2007.097428
DO - 10.1373/clinchem.2007.097428
M3 - Article
C2 - 18451314
AN - SCOPUS:47549083869
SN - 0009-9147
VL - 54
SP - 1149
EP - 1157
JO - Clinical chemistry
JF - Clinical chemistry
IS - 7
ER -