Patologìâ (Dec 2015)
Value of circulating N-terminal pro-brain natriuretic peptide for prognosis of cardiovascular events in patients with non-Hodgkin lymphoma in remission
Abstract
Purpose – to evaluate the prognostic value of circulating NT-proBNP for cardiovascular events, cumulative survival in patients with non-Hodgkin lymphoma in remission. Materials and methods. Eighty two subjects with non-Hodgkin lymphoma in full or partial remission were enrolled in the study. Observation period was up to 12 months. Blood samples for biomarkers measurements were collected. ELISA method for measurements of circulating level of NT-proBNP was used. Hemodynamic evaluation was performed by transthoracic echocardiography. Results and discussion. Fifty three cumulative clinical events occurred in 21 patients (25.6%) within the follow-up, with their distribution being as follows: 5 cardiovascular deaths, 24 cardiac arrhythmias, 8 cardiac ischemic events, 1 stroke, 9 chronic heart failures and 6 hospital admissions for cardiovascular reasons. Circulating levels of NT-proBNP in free-events subject cohort and subjects cohort with cardiovascular events were 7.71 ng/ml (95% confidence interval [CI] = 4.36-11.07 ng/ml) and 18.73 ng/ml (95% CI = 3.01-34.44 ng/ml) (p=0,71). Nevertheless, NT-proBNP in cohort of patients without heart failure and cohort with heart failure were 7.13 ng/ml (95% CI = 4.50-9.75 ng/ml) and 31.51 ng/ml (95% CI = 0.18-63.19 ng/ml) (p=0.03). In multivariate logistic regression circulating NT-proBNP independently predicted heart failure (odds ratio [OR] = 1,04; 95% CI = 1,02–1,09; р<0,05) within 12 months of observation period. Conclusions. Among patients with non-Hodgkin lymphoma in remission association of circulating NT-proBNP and cumulative cardiovascular events within 12 months is insufficient. In these patients increased circulating NT-proBNP may associate with appearance of heart failure within 12 months. Using of combination of NT-proBNP with other markers holds promise for prognosis of cardiovascular events in patients with non-Hodgkin lymphoma in remission.
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