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This Article Full Text Full Text (PDF) Supplemental Data All Versions of this Article: clinchem.2007.097428v1 54/7/1149    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Brune, K. Articles by Giannitsis, E. Search for Related Content PubMed PubMed Citation Articles by Brune, K. Articles by Giannitsis, E. Related Collections Proteomics and Protein Markers

N-Terminal Pro–B-Type Natriuretic Peptide Concentrations Predict the Risk of Cardiovascular Adverse Events from Antiinflammatory Drugs: A Pilot Trial

¹ Department of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany; ² Department of Internal Medicine, University Hospital of Heidelberg, Heidelberg, Germany; ³ DIAneering GmbH, Diagnostics Engineering, Research and Know-How Services, Heidelberg, Germany; ⁴ Cardiovascular Division, Department of Internal Medicine and Department of Laboratory Medicine and Pathology, Mayo Clinic and Mayo Medical School, Rochester, MN.

^aAddress correspondence to this author at: Mayo Clinic, Gonda Bldg., 5th Floor, 200 First St., Rochester, MN 55905. E-mail jaffe.allan{at}mayo.edu.

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 cyclooxygenase-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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				J. L. Januzzi Jr Use of Biomarkers to Predict Cardiac Risk from Medications: Getting to the Heart of the Matter Clin. Chem., July 1, 2008; 54(7): 1107 - 1109. [Full Text] [PDF]