Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide and High-Sensitivity Troponin T Levels in the Natural History of Transthyretin Amyloid Cardiomyopathy and Their Evolution after Tafamidis Treatment - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Medicine Année : 2021

Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide and High-Sensitivity Troponin T Levels in the Natural History of Transthyretin Amyloid Cardiomyopathy and Their Evolution after Tafamidis Treatment

Silvia Oghina
Constant Josse
  • Fonction : Auteur
Marc-Antoine Delbarre
  • Fonction : Auteur
Damien Eyharts
  • Fonction : Auteur
Amira Zaroui
  • Fonction : Auteur
Soulef Guendouz
  • Fonction : Auteur
Arnault Galat
  • Fonction : Auteur
Luc Hittinger
  • Fonction : Auteur
Pascale Fanen
  • Fonction : Auteur
Emmanuel Teiger
  • Fonction : Auteur
Nadir Mouri
  • Fonction : Auteur
François Montestruc
  • Fonction : Auteur
Thibaud Damy
  • Fonction : Auteur

Résumé

Background: We assesse the evolution and prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (cTnT-HS) in transthyretin amyloid cardiomyopathy (ATTR-CA) before and after tafamidis treatment. Methods and Results: 454 ATTR-CA patients without tafamidis (Cohort A) and 248 ATTR-CA with tafamidis (Cohort B) were enrolled. Event-free survival (EFS) events were death, heart transplant, or acute heart failure. In Cohort A, 27% of patients maintained NT-proBNP < 3000 ng/L and 14% cTnT-HS < 50 ng/L at 12 months relative to baseline levels. In Cohort B, the proportions were 49% and 29%, respectively. In Cohort A, among the 333 patients without an increased NT-proBNP > 50% relative to baseline EFS was extended compared to the 121 patients with an increased NT-proBNP > 50% (HR: 0.75 [0.57; 0.98]; p = 0.032). In Cohort A, baseline NT-proBNP > 3000 ng/L and cTnT-HS > 50 ng/L and a relative increase of NT-proBNP > 50% during follow-up were independent prognostic factors of EFS. The slopes of logs NT-proBNP and cTnT-HS increased with time before and stabilized after tafamidis. Conclusion: ATTR-CA patients with increasing NT-proBNP had an increased risk of EFS. Tafamidis stabilize NT-proBNP and cTnT-HS increasing, even if initial NT-proBNP levels were >3000 ng/L. Thus suggesting that all patients, irrespective of baseline NT-proBNP levels, may benefit from tafamidis.

Dates et versions

hal-04392284 , version 1 (13-01-2024)

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Citer

Silvia Oghina, Constant Josse, Mélanie Bézard, Mounira Kharoubi, Marc-Antoine Delbarre, et al.. Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide and High-Sensitivity Troponin T Levels in the Natural History of Transthyretin Amyloid Cardiomyopathy and Their Evolution after Tafamidis Treatment. Journal of Clinical Medicine, 2021, 10 (21), pp.4868. ⟨10.3390/jcm10214868⟩. ⟨hal-04392284⟩

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