N-terminal pro-brain natriuretic peptide is a strong predictor of mortality in systemic sclerosis

Yannick Allanore, Andras Komocsi, Serena Vettori, Eric Hachulla, Nicolas Hunzelmann, Jörg Distler, Jérôme Avouac, Camille Gobeaux, David Launay, Laszlo Czirjak, André Kahan, Christophe Meune

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Abstract

Objectives Cardiovascular involvement is a major contributor to mortality in systemic sclerosis (SSc). We examined whether N-terminal pro-brain natriuretic peptide (NT-proBNP) is a reliable predictor of mortality in SSc. Methods and results This multicentre prospective cohort study included 523 patients presenting with SSc, whose mean age was 54 ± 13 years, mean disease duration 8 ± 9 years, and diffuse cutaneous form in 168. Plasma NT-proBNP was measured at baseline and the patients were followed yearly. Overall mortality was measured at 3 years. At baseline, cardiovascular involvement was present in 37 patients, including 17 with pulmonary artery hypertension (PAH) and 20 with a left ventricular ejection fraction (LVEF) < 55%. At 3 years, 32 (7%) patients had died. The median [25th–75th percentile] NT-proBNP concentration was 203 ng/l [129–514] in patients who died within 3 years, versus 88 ng/l [47–167] in survivors (P < 0.001). NT-proBNP was an independent predictor of 3-years mortality in multivariate analysis (P = 0.046). The optimal cut-off derived from the ROC curve was 129 ng/l; sensitivity and specificity to predict 3 y mortality were 78.1 and 66.7%. Using the previously recommended 125-ng/l concentration as threshold value, NT-proBNP reliably and independently predicted 3 year mortality, with a sensitivity of 78.1 and a negative predictive value of 97.6%, respectively (P = 0.006). The consideration of SSc patients without PAH or LVEF < 55% at baseline yielded similar results. Conclusion NT-proBNP appears as a reliable and independent predictor of mortality in patients with SSc.

Original languageEnglish
Pages (from-to)385-389
Number of pages5
JournalInternational Journal of Cardiology
Volume223
DOIs
Publication statusPublished - Nov 15 2016

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Keywords

  • Cardiovascular mortality
  • N-terminal pro-brain natriuretic peptide
  • Pulmonary artery hypertension
  • Systemic sclerosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Allanore, Y., Komocsi, A., Vettori, S., Hachulla, E., Hunzelmann, N., Distler, J., Avouac, J., Gobeaux, C., Launay, D., Czirjak, L., Kahan, A., & Meune, C. (2016). N-terminal pro-brain natriuretic peptide is a strong predictor of mortality in systemic sclerosis. International Journal of Cardiology, 223, 385-389. https://doi.org/10.1016/j.ijcard.2016.08.246