N-terminal-proB-type natriuretic peptide predicts cardiovascular disease events in HIV-infected patients

AIDS. 2011 Mar 13;25(5):651-7. doi: 10.1097/QAD.0b013e32834404a1.


Background: Cardiovascular disease (CVD) is increasing in HIV-infected patients. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a significant predictor of CVD in the general population. We aimed to quantify the risk of CVD events associated with NT-proBNP at baseline in the Strategies for Management of Anti-Retroviral Therapy study.

Methods: In a nested case-control study, NT-proBNP was measured at baseline in 186 patients who experienced a CVD event over an average of 2.8 years of follow-up and in 329 matched controls. Odds ratios (ORs) associated with baseline levels of NT-proBNP for CVD were estimated using conditional logistic regression.

Results: At baseline median NT-proBNP [interquartile range (IQR)] was 48.1 (18.5, 112.9) pg/ml in patients who developed a CVD event and 25.7 (12.4, 50.2) pg/ml in controls. The unadjusted OR for the highest versus the lowest quartile was 3.7 [95% confidence interval (CI) 2.1-6.5, P < 0.0001]. After adjustment for baseline covariates and CVD risk factors, OR was 2.8 (95% CI 1.4-5.6, P = 0.003); with additional adjustment for IL-6, high-sensitivity C-reactive protein and D-dimer, OR was 2.3 (95% CI 1.1-4.9, P = 0.02).

Conclusions: Higher levels of NT-proBNP are associated with increased risk of CVD in HIV patients after considering established CVD risk factors and markers for inflammation and thrombosis.

Trial registration: ClinicalTrials.gov NCT00027352.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / metabolism*
  • Case-Control Studies
  • Creatine / metabolism*
  • Female
  • HIV Infections / complications
  • HIV Infections / metabolism*
  • HIV-1*
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / metabolism*
  • Peptide Fragments / metabolism*
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment


  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Creatine

Associated data

  • ClinicalTrials.gov/NCT00027352