Value of circulating N-terminal pro-brain natriuretic peptide for prognosis of cardiovascular events in patients with non-Hodgkin lymphoma in remission

Authors

  • B. B. Samura Zaporizhzhia State Medical University,

DOI:

https://doi.org/10.14739/2310-1237.2015.3.55590

Keywords:

NT-proBNP, Non-Hodgkin Lymphoma, Survival, Prognosis

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.

References

Adzersen, K. H., Friedrich, S., & Becker, N. (2015) Are epidemiological data on lymphoma incidence comparable? Results from an application of the coding recommendations of WHO, InterLymph, ENCR and SEER to a cancer registry dataset. J. Cancer Res. Clin. Oncol., Jul 24. doi: 10.1007/s00432-015-2017-z.

Gardin, J. M., Adams, D. B., Douglas, P. S., Feigenbaum, H., Forst, D. H., Fraser, A. G., et al. (2002) American Society of Echocardiography. Recommendations for a standardized report for adult transthoracic echocardiography: a report from the American Society of Echocardiography's Nomenclature and Standards Committee and Task Force for a Standardized Echocardiography Report. J. Am. Soc. Echocardiogr, 15(3), 275–290.

Chen, M. H., Blackington, L .H., Zhou, J., Chu, T. F., Gauvreau, K., Marcus, K. J., et al. (2014) Blood pressure is associated with occult cardiovascular disease in prospectively studied Hodgkin lymphoma survivors after chest radiation. Leuk. Lymphoma, 55(11), 2477–2483. doi: 10.3109/10428194.2013.879716.

van Nimwegen, F. A., Schaapveld, M., Janus, C. P., Krol, A. D., Petersen, E. J., Raemaekers, J. M., et al. (2015) Cardiovascular disease after Hodgkin lymphoma treatment: 40-year disease risk. JAMA Intern. Med., 175(6), 1007–1017. doi: 10.1001/jamainternmed.2015.1180.

Lewandrowski, K. (2009) Point-of-care testing for cardiac markers in acute coronary syndromes and heart failure. Clin. Lab. Med., 29(3), 561–571. doi: 10.1016/j.cll.2009.06.007.

Moser, E. C., Noordijk, E. M., van Leeuwen, F. E., le Cessie, S., Baars, J. W., et al. (2006) Long-term risk of cardiovascular disease after treatment for aggressive non-Hodgkin lymphoma. Blood, 107(7), 2912–2919.

Cheson, B. D., Fisher, R. I., Barrington, S. F., Cavalli, F., Schwartz, L. H, Zucca, E., & Lister, T. A. (2015) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J. Clin. Oncol., 32(27), 3059–3068.

Mladosievicova, B., Urbanova, D., Radvanska, E., Slavkovsky, P., & Simkova, I. (2012) Role of NT-proBNP in detection of myocardial damage in childhood leukemia survivors treated with and without anthracyclines. J. Exp. Clin. Cancer Res., 31(86), 86. doi: 10.1186/1756-9966-31-86.

Romano, S., Fratini, S., Ricevuto, E., Procaccini, V., Stifano, G., Mancini, M., et al. (2011) Serial measurements of NT-proBNP are predictive of not-high-dose anthracycline cardiotoxicity in breast cancer patients. Br. J. Cancer., 105(11), 1663–1668. doi:10.1038/bjc.2011.439.

Balion, C., Santaguida, P. L., Hill, S., Worster, A., McQueen, M., Oremus, M., et al. (2006) Testing for BNP and NT-proBNP in the diagnosis and prognosis of heart failure Evid. Rep. Technol. Assess. (Full Rep), 142, 1–147.

Tsai, H. T., Pfeiffer, R. M., Warren, J., & Landgren, O. (2015) The effects of cardiovascular disease on the clinical outcome of elderly patients with diffuse large B-cell lymphoma. Leuk. Lymphoma., 56(3), 682–687. doi: 10.3109/10428194.2014.921914.

Al-Kindi, S. G., Abu-Zeinah, G. F., Kim, C. H., Hejjaji, V., William, B. M., Caimi, P. F., & Oliveira, G. H. (2015) Trends and Disparities in Cardiovascular Mortality Among Survivors of Hodgkin Lymphoma. Clin. Lymphoma Myeloma Leuk., Aug 5, 2152–2650. doi: 10.1016/j.clml.2015.07.638.

How to Cite

1.
Samura BB. Value of circulating N-terminal pro-brain natriuretic peptide for prognosis of cardiovascular events in patients with non-Hodgkin lymphoma in remission. Pathologia [Internet]. 2015Dec.18 [cited 2024Nov.22];(3). Available from: http://pat.zsmu.edu.ua/article/view/55590

Issue

Section

Original research