Nt-proBNP IN YOUNG PATIENTS WITH RHEUMATOID ARTHRITIS: RELATIONSHIP WITH CLINICAL AND LABORATORY CHARACTERISTICS OF ARTHRITIS AND ATHEROSCLEROSIS
Summary. Introduction. Rheumatoid arthritis (RA) is associated with the early development of atherosclerosis-dependent diseases in young patients (18–44 years). Modern medicine continues to search for the valid marker of cardiovascular disease (CVD) that could help physicians identify patients who need additional investigations to reduce risk of fatal cardiovascular complications. Such a marker may be Nt-proBNP, but its diagnostic value need to be clarified in RA. Aim of the study. To study the level of Nt-proBNP in young RA patients without coronary heart disease (CHD) and heart failure (HF) with different clinical and laboratory characteristics of arthritis and its relationships with indicators of activity and duration of RA, vascular wall condition and medications. Materials and methods. We examined 62 young RA patients without CHD and HF (main group) and 50 matched healthy individuals (control group). Results. In 54.8% of patients in the main group and in 6.0% of the control group found elevated levels of Nt-proBNP >300 pg/ml (p<0.05), and in 19.3% of patients with RA found very high rates — more than 1000 pg/ml. In 38.7% of patients and 14% of the control group revealed an increased CIMT ≥0.9 mm (p<0.05), which was accompanied by an increase in Nt-proBNP. The highest levels of Nt-proBNP (1480±552 pg/ml) were found among women older than 37 years with a duration of RA over 5 years, with moderate DAS28 (3.2–5.1) and high (>5.2) activity arthritis, accompanied by the presence of chronic anemia (Hb <109 g/l) and the value of CIMT≥0.9 mm. Conclusion. Elevated levels of Nt-proBNP are closely related to the characteristics of arthritis (duration and activity of RA), the presence of chronic anemia and associated with increased CIMT, which may indicate the importance of propeptide as an integral marker of inflammatory process in RA and a marker of atherogenesis in preclinical cardiovascular disease.
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