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Elevated NT-pro-brain natriuretic peptide level is independently associated with all-cause mortality in HIV-infected women in the early and recent HAART eras in the women's interagency HIV study cohort

Gingo, MR and Zhang, Y and Ghebrehawariat, KB and Jeong, JH and Chu, Y and Yang, Q and Lucht, L and Hanna, DB and Lazar, JM and Gladwin, MT and Morris, A (2015) Elevated NT-pro-brain natriuretic peptide level is independently associated with all-cause mortality in HIV-infected women in the early and recent HAART eras in the women's interagency HIV study cohort. PLoS ONE, 10 (3).

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Abstract

© 2015 Gingo et al. Background: HIV-infected individuals are at increased risk of right and left heart dysfunction. N-terminal-pro-brain natriuretic peptide (NT-proBNP), a marker of cardiac ventricular strain and systolic dysfunction, may be associated with all-cause mortality in HIV-infected women. The aim of this study was to determine if elevated levels of NT-proBNP is associated with increased mortality in HIV-infected women. Design: Prospective cohort study. Methods and Results: We measured NT-proBNP in 936 HIV-infected and 387 age-matched HIV-uninfected women early (10/11/94 to 7/17/97) and 1082 HIV-infected and 448 HIV-uninfected women late (4/1/08 to 10/7/08) in the highly active antiretroviral therapy (HAART) periods in the Women's Interagency HIV Study. An NT-proBNP >75th percentile was more likely in HIV-infected persons, but only statistically significant in the late period (27% vs. 21%, unadjusted p = 0.03). In HIV-infected participants, NT-proBNP>75th percentile was independently associated with worse 5-year survival in the early HAART period (HR 1.8, 95% CI 1.3-2.4, p<0.001) and remained a predictor of mortality in the late HAART period (HR 2.8, 95% CI 1.4-5.5, p = 0.002) independent of other established risk covariates (age, race/ethnicity, body mass index, smoking, hepatitis C serostatus, hypertension, renal function, and hemoglobin). NT-proBNP level was not associated with mortality in HIV-uninfected women. Conclusion: NT-proBNP is a novel independent marker of mortality in HIV-infected women both when HAART was first introduced and currently. As NT-proBNP is often associated with both pulmonary hypertension and left ventricular dysfunction, these findings suggest that these conditions may contribute significantly to adverse outcomes in this population, requiring further definition of causes and treatments of elevated NT-proBNP in HIV-infected women.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Gingo, MR
Zhang, Y
Ghebrehawariat, KBkig11@pitt.eduKIG11
Jeong, JHjjeong@pitt.eduJJEONG
Chu, Yyac20@pitt.eduYAC20
Yang, Qquy2@pitt.eduQUY2
Lucht, L
Hanna, DB
Lazar, JM
Gladwin, MT
Morris, A
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorPassino, ClaudioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 26 March 2015
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: PLoS ONE
Volume: 10
Number: 3
DOI or Unique Handle: 10.1371/journal.pone.0123389
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Biostatistics
School of Medicine > Critical Care Medicine
School of Medicine > Immunology
Refereed: Yes
Date Deposited: 23 Aug 2016 13:57
Last Modified: 25 Jun 2018 13:57
URI: http://d-scholarship.pitt.edu/id/eprint/28493

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