Can NT-proBNP Predict Outcomes in Patients With HIV and HF?

Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration may predict outcomes among patients living with HIV and heart failure (HF), according to new study findings.

Although it is well known that patients with HIV have higher rates of incident HF and worse outcomes after an event, the role of NT-proBNP concentrations has not been explored.

To conduct their analysis, the researchers assessed the NT-proBNP concentrations of patients hospitalized with HF at an academic center in a calendar year. The concentrations were then compared between patients with HIV (n=434) and those without HIV (n=2144).

The results of their analysis showed that patients with HIV had higher admission rates, higher discharge rates, and lower admission-to-discharge changes in NT-proBNP concentrations compared with patients without HIV.

Results were similar after stratifying for left ventricular ejection fraction.

Higher NT-proBNP concentrations were associated with cocaine use, a lower left ventricular ejection fraction, a higher New York Heart Association class, a higher viral load (VL), and a lower CD4 count in a multivariate analysis.

Patients with HIV who had a higher NT-proBNP concentration at admission had an increased risk of cardiovascular mortality in follow-up.

“Among [patients with HIV], each doubling of NT-proBNP was associated with a 19% increased risk of death,” the researchers concluded. “However, among patients living without HIV, each doubling was associated with a 27% increased risk; this difference was attenuated among [patients with HIV] with lower VLs and higher CD4 counts.”

—Amanda Balbi

Reference:

Alvi RM, Zanni MV, Neilan AM, et al. Amino-terminal pro-B-type natriuretic peptide among patients living with both human immunodeficiency virus and heart failure. Clin Infect Dis. 2020;71(5):1306-1315. https://doi.org/10.1093/cid/ciz958