Clinical value of serum NT-proBNP level in the diagnosis of rheumatoid arthritis with cardiac insufficiency

Objective: To investigate the clinical value of serum sputum end-type natriuretic peptide (NT-proBNP) level in the diagnosis of rheumatoid arthritis (RA) with cardiac insufficiency. Method: A total of 419 patients with RA and cardiac insufficiency admitted to Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine from June 2016 to June 2017 were included. (1) Analysis of the correlation between the patients' basic characteristics, such as age and gender, and the NT-proBNP level; (2) Analysis of the correlation between the NT-proBNP level and cardiac function indexes, left ventricular ejection fraction (LVEF) and TDI-Tei; (3) Analysis of the correlation between the NT-proBNP level and Rheumatoid related factors, such as Anti-citrullinated fibrinogen (ACF) and anti-cyclic cirullinated peptide (CCP resistance); (4) The application of NT-proBNP level in the prognostic evaluation of patients with RA complicated with cardiac insufficiency within 2 years for cardiovascular incidence and mortality. Results: The 419 patients were divided into high NT-proBNP group and low NT-proBNP group with 4647 pg/ml as the boundary. Between the two groups, there were no statistically significant differences in age, gender, BMI and vascular risk factors, but in the high NT-proBNP group, cardiac function (P<0.05) and rheumatoid factor levels (P<0.05) were elevated as compared with the low NT-proBNP group. The area under the ROC curve of cardiovascular events in patients with CRS, as predicted according to the NT-proBNP level, was 0.838, while the sensitivity and specificity were 88.9% and 75.0%, respectively. The NT-proBNP level of 4647 pg/ml was used as the cut-off value to establish the incidence curve of cardiovascular events for patients at different levels of NT-proBNP during the 2-year follow-up period by Kaplan-Meier method, and the Log-rank value was 51.673 (P<0.001). Conclusion: The circulating level of NT-proBNP is a prognostic biomarker for patients with RA with cardiac insufficiency.