Abstract 16844: Brain Natriuretic Peptides in Patients with Transthyretin Amyloidosis - Report from the Transthyretin Amyloidosis Outcome Survey (THAOS)
Measurement of natriuretic peptides (NP) has been established as helpful markers in several diseases, including AL amyloidosis. Data on NP among different forms of transthyretin (TTR) amyloidosis is lacking. THAOS, a large multicenter observational study of TTR amyloidosis, provides more insight into this topic. In total, for 701 patients brain natriuretic peptide (BNP; n=533) or n-terminal proBNP (NT-proBNP; n=170) were available (57.5% of the overall THAOS population). Patients were divided according to their TTR forms: wild-type (WT) vs. mutant (MT) TTR; Val30Met vs. non-Val30Met mutations. BNP or NT-proBNP levels were divided in 4 25%-quantiles and subsequently pooled according to the quantiles. Data are mean±SD; statistical tests are based on Chi-square and Wilcoxon rank-sum or Krustal Wallis test. Study cohort (age 46±17 years) consisted of 52 WT and 649 MT (Val30Met n=554). BNP and NT-proBNP levels were higher in WT than MT (BNP: 569±279 vs. 462±2235 pg/mL; p<0.001; NT-proBNP: 19611±40535 vs. 1662±5356 pg/mL; p<0.001). BNP and NT-proBNP levels were higher in non-Val30Met as compared to the Val30Met patients (BNP 519±544 vs. 457±2324 pg/mL; p<0.001; NT-proBNP 3314±7970 vs. 547±1600 pg/mL; p<0.05). Combined quantiles revealed Q1 179 patients, Q2 171 patients, Q3 175 patients, and Q4 176 patients. Mean BNP was Q1 17.7±7.7 pg/mL, Q2 46.7±10.1 pg/mL, Q3 105.7±33.4 pg/mL, Q4 1682±4170 pg/mL (p<0.001); mean NT-proBNP was Q1 36.9±13.5 pg/mL; Q2 121.3±43.4 pg/mL; Q3 929.1±633.0 pg/mL; Q4 21002±37272 pg/mL (p<0.001). Age increased within the quantiles (Q1 37±12; Q2 38±11; Q3 45±17; Q4 62±16 years, p<0.001). There was no correlation of logBNP or logNTproBNP with disease duration. A higher prevalence of the non-Val30Met mutation was in Q4 (43.8%) as compared to Q1, Q2, and Q3 (11.2%; 9.9%, 18.9%), respectively. Highest prevalence of liver transplant (Val30Met n=94, non-Val30Met n=10)was in Q4 (Q1 5.0%; Q3 11.7%; Q3 20.6%, Q4 22.2%; p<0.001). Highest levels NP were seen in WT, lowest in Val30Met patients. NP level was associated with age, but not gender. Interestingly, liver transplant was more common in patients with high NP levels. Further analysis are mandatory to evaluate the diagnostic and prognostic role of NP in different forms of TTR amyloidosis.
- © 2012 by American Heart Association, Inc.