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NT-proBNP predicts mortality in patients with rheumatoid arthritis: results from 10-year follow-up of the EURIDISS study
  1. Sella Provan1,
  2. Kristin Angel2,3,
  3. Anne Grete Semb1,
  4. Dan Atar2,3,
  5. Tore K Kvien1
  1. 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2University of Oslo, Oslo, Norway
  3. 3Division of Cardiology, Oslo University Hospital Aker, Oslo, Norway
  1. Correspondence to Dr Sella A Provan, Department of Rheumatology, Diakonhjemmet Hospital, Pb 23 Vindern, N-0319 Oslo, Norway; s-provan{at}diakonsyk.no

Abstract

Objectives Patients with rheumatoid arthritis (RA) have a higher mortality than the general population, and this increased mortality is related to demographic and disease variables. N-terminal pro-brain natriuretic peptide (NT-proBNP) is a predictor of mortality both in general and patient populations, but has not been shown to predict mortality in patients with RA. This study examines whether NT-proBNP can further improve the prediction of mortality in RA.

Methods 182 patients with RA of 5–9 years disease duration were comprehensively examined in 1997. Serum samples were frozen and later batch analysed for NT-proBNP levels and other biomarkers. Adjusted univariate and logistic regression analyses were performed with death within the 10-year follow-up period as the dependent variable. Significant predictors were also examined as dichotomised variables.

Results Mortality was predicted in univariate analyses by the following variables: age, sex, homozygosity for HLA-DRB1 shared epitope alleles, Health Assessment Questionnaire, 28-joint Disease Activity Score (DAS28) and NT-proBNP. A multivariate model with age, sex, DAS28 and NT-proBNP as independent variables showed the greatest discrimination.

Conclusion NT-proBNP provided incremental information in the prediction of mortality in this cohort of patients with RA.

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Footnotes

  • Funding This study was supported by grants from the Eastern Norway Regional Health Authority. The data collection in EURIDISS was supported by The Research Council of Norway, The Norwegian Rheumatism Association, The Norwegian Women Public Health Association, the Grethe Harbitz Legacy and the Marie and Else Mustad's Legacy.

  • Competing interests None.

  • Ethics approval The project was approved by the Norwegian Regional Committee for Research Ethics.

  • Patient approval Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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