Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


The Relationship between N Terminal Pro Brain Natriuretic Peptide (NT-proBNP) and Atherosclerosis in SLE Patients.

Goldenberg2,  Diana, Miller2,  Emily, Sattar3,  Naveed, Welsh4,  Paul, Roman5,  Mary, Salmon1,  Jane E.

Hospital for Special Surgery, New York, NY
Hospital for Special Surgery, New York, NY
University of Glasgow, Glasgow, United Kingdom
University of Glasgow
Weill Cornell Medical College, New York, NY

Background:

NT-proBNP is a biomarker of cardiovascular health in the general population that is independently associated with heart failure, coronary artery disease, stroke and death. It has been suggested that serum NT-proBNP levels are higher in SLE patients than controls, but its relationship with markers of atherosclerosis is still unclear. Because traditional cardiac risk factors do not adequately identify the SLE patients with increased risk for premature atherosclerosis, there is a need for a biomarker to improve risk stratification. The aim of this study was to investigate the relationship between NT-proBNP and atherosclerosis in SLE patients.

Methods:

One hundred and twenty four patients meeting American College of Rheumatology diagnostic criteria for SLE who were participating in a longitudinal study of cardiovascular disease at the Hospital for Special Surgery were studied. Patients underwent clinical and laboratory assessment, echocardiography and carotid artery ultrasonography to detect plaque. Patients were defined as having atherosclerosis based on whether they had plaque (focal protrusion >50% of the thickness of the surrounding wall) on carotid ultrasonography. Echocardiography was performed and left ventricular ejection fraction, degree of mitral regurgitation and left atrial diameter were measured. SLEDAI was used to calculate SLE disease activity. Serum NT-proBNP levels were measured using a clinically validated electrochemiluminescence method (Roche Elecsys 2010). Group differences in NT-proBNP were compared using t-tests and independent correlates of NT-BNP and plaque were determined by multivariate regression analysis.

Results:

The mean age of the124 SLE patients was 43.4 ± 13.7 years and 95.2% of the patients were female. Atherosclerotic plaque was present in 38.2 %. The mean SLEDAI score was 3.7± 4.8; range 0–22. Only 2.6% of the patients had diabetes and 12.7% were current smokers. Mean serum NT-proBNP was 346.1±1251 pg/ml (median 82.5 pg/ml, range 5–12905 pg/ml). As a reference, the baseline median NT-proBNP level measured using a similar electrochemiluminescence method in women in the general population was 66 pg/mL. Log transformed NT-proBNP was associated with higher left atrial diameter, lower body mass index and lower ejection fraction. SLE patients with atherosclerosis had higher NT-proBNP levels than SLE patients without atherosclerosis (615.4 pg/ml ± 286.5 vs 151.7 pg/ml ± 27.4; P = 0.044. However, in our regression models neither serum log NT-proBNP, gender, BMI nor SLEDAI predicted plaque. Age and lower ejection fraction were the only independent correlates of plaque.

Conclusions:

In our analysis of 124 SLE patients with and without atherosclerosis, serum NT-proBNP levels correlated with plaque presence on carotid ultrasonography. As anticipated, it is likely that age and markers of cardiac function are in part mediating this relationship in our patient population. Prospective studies are now needed to determine the utility of NT-proBNP as a biomarker for predicting atherosclerosis in SLE patients.

To cite this abstract, please use the following information:
Goldenberg, Diana, Miller, Emily, Sattar, Naveed, Welsh, Paul, Roman, Mary, Salmon, Jane E.; The Relationship between N Terminal Pro Brain Natriuretic Peptide (NT-proBNP) and Atherosclerosis in SLE Patients. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :483
DOI: 10.1002/art.28252

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