N-terminal pro-brain natriuretic peptide (NT-proBNP) is independently and significantly linked to markers of both rheumatic disease activity and cardiovascular disease in patients with rheumatoid arthritis (RA), study findings show.
The N-terminal fragment of BNP, known as NT-proBNP, is a validated marker of cardiac morbidity and mortality in generally healthy individuals, as well as those with stable coronary heart disease and a history of heart failure.
However, the potential for links between markers of RA disease activity and NT-proBNP levels has not been explored and it is not clear whether RA treatment affects levels of the hormone, say Sella Provan, from Diakonhjemmet Hospital in Oslo, Norway, and colleagues.
Provan and team performed a 10-year longitudinal study of 238 individuals who had had RA for a maximum of 4 years.
The researchers report in the journal Arthritis Research and Therapy that baseline levels of the inflammatory biomarker C-reactive protein were cross-sectionally, significantly related to NT-proBNP levels, even after adjustment for potentially confounding factors including age, sex and creatinine levels.
Duration of RA was likewise significantly associated with levels of the marker, after adjusting for potential confounders.
Levels of C-reactive protein remained significantly related to NT-proBNP concentrations when analyzed longitudinally over the 10-year follow-up period, and after adjusting for confounders.
Provan and colleagues say its prospective longitudinal design and regular clinical examinations areparticular strengths of their study, but add that the relatively small study population weakens the validity of their findings.
Despite this, the researchers say the linear associations between C-reactive protein and NT-proBNP levels in RA patients deserves further investigation "to elucidate how this hormonal biomarker can be implemented in clinical decision making in RA."