N-terminal-proB-type natriuretic peptide predicts cardiovascular disease events in HIV-infected patients

作者：Duprez Daniel A^*; Neuhaus Jacqueline; Tracy Russell; Kuller Lewis H; Deeks Steven G; Orkin Chloe; Stoehr Albrecht; Woolley Ian J; Neaton James D

来源：AIDS, 2011, 25(5): 651-657.

DOI：10.1097/QAD.0b013e32834404a1

• AIDS
• antiretroviral therapy
• cardiovascular disease events
• HIV
• NT-proBNP
• SMART

Background: Cardiovascular disease (CVD) is increasing in HIV-infected patients. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a significant predictor of CVD in the general population. We aimed to quantify the risk of CVD events associated with NT-proBNP at baseline in the Strategies for Management of Anti-Retroviral Therapy study.
Methods: In a nested case-control study, NT-proBNP was measured at baseline in 186 patients who experienced a CVD event over an average of 2.8 years of follow-up and in 329 matched controls. Odds ratios (ORs) associated with baseline levels of NT-proBNP for CVD were estimated using conditional logistic regression.
Results: At baseline median NT-proBNP [interquartile range (IQR)] was 48.1 (18.5, 112.9) pg/ml in patients who developed a CVD event and 25.7 (12.4, 50.2) pg/ml in controls. The unadjusted OR for the highest versus the lowest quartile was 3.7 [95% confidence interval (CI) 2.1-6.5, P < 0.0001]. After adjustment for baseline covariates and CVD risk factors, OR was 2.8 (95% CI 1.4-5.6, P=0.003); with additional adjustment for IL-6, high-sensitivity C-reactive protein and D-dimer, OR was 2.3 (95% CI 1.1-4.9, P=0.02).
Conclusions: Higher levels of NT-proBNP are associated with increased risk of CVD in HIV patients after considering established CVD risk factors and markers for inflammation and thrombosis.

• 出版日期2011-3-13