Sevcan UĞUR, Ayşegül KURTOĞLU, Bülent BÜTÜN

Kalp hastalığı olmayan romatoid artritli hastalarda hastalık aktivitesi ile nt-pro bnp düzeyleri arasındaki ilişki

Amaç: Romatoid artrit (RA)’te kardiyovasküler komplikasyonlar sık ortaya çıkmaktadır. Bu komplikasyonlar arasında perikardit, miyokardit, kardiyak amiloidoz, koroner vaskülit, aritmi ve kapak hastalığı olduğu gibi konjestif kalp yetmezliği ve iskemik kalp hastalıkları da bulunmaktadır. Bu nedenle romatoid artritli hastalarda normal popülasyona göre mortalite ve morbidite daha sık görülmektedir. Son yıllarda N terminal pro beyin natriüretik peptid (NT-proBNP) kardiyak yetmezliğinin tanısında kullanılmaktadır. Biz bu çalışmada RA’li hastalarda hastalık aktivitesi ile NT-proBNP seviyeleri arasındaki ilişkiyi belirlemeyi amaçladık. Gereç ve Yöntem: Kalp hastalığı öyküsü olmayan 77 RA’li hasta ve 31 sağlıklı kontrol grubunda serum NT-proBNP, eritrosit sedimentasyon hızı, C reaktif protein düzeyleri ölçüldü. DAS 28 skoruna göre NT-proBNP düzeyleri karşılaştırıldı. Bulgular: Hastaların NT-proBNP düzeyleri ile yaş, beden kitle indeksi ve C reaktif protein düzeyleri arasında pozitif korelasyon vardı. NT-proBNP düzeyleri ile hastalık aktivitesi arasında anlamlı bir farklılık tespit edilmedi. Sonuç: NT-proBNP düzeyleri ile C reaktif protein düzeyleri arasında korelasyon vardır. Hastalık aktivitesi ile arasındaki ilişkiyi değerlendiren çok sayıda hasta ve spesifik gruplarda yapılmış çalışmalara ihtiyaç vardır.

Objective: Cardiovascular features in rheumatoid arthritis (RA) are comman. These complications include pericarditis, myocarditis, cardiac amyloidosis, coronary vasculitis, arrhythmia and valve disease, as well as congestive heart failure and ischemic heart disease. For this reason, mortality and morbidity are more common in patients with RA than in the normal population. In recent years, N-terminal pro-brain natriuretic peptide (NT-proBNP) has been used to identify cardiac failure. In this study, we aimed to determine the relationship between disease activity and NT-proBNP levels in patients with RA. Material and Methods: Serum NT-proBNP, erythrocyte sedimentation rate, C-reactive protein levels were measured in 77 patients with RA and 31 healthy control groups without cardiac disease history. NT-proBNP levels were compared according to DAS 28 score. Results: There was a positive correlation between NT-proBNP levels of patients and age, body mass index and C reactive protein levels. There was no significant difference between NT-proBNP levels and disease activity. Conclusion: The NT-proBNP correlates with the C-reactive protein. There is a need for studies in a large number of patients and specific groups evaluating the relationship with disease activity.

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