AB0545 DYNAMICS OF N-TERMINAL FRAGMENT OF BRAIN NATRIURETIC PEPTIDE PROGENITOR LEVEL IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS, WITHOUT HEART FAILURE SIGNS BEFORE AND AFTER IMMUNOSUPPRESSIVE THERAPY

Background: Cardiovascular mortality is increased in systemic lupus erythematosus (SLE). Elevated plasma concentration of N-terminal fragment of brain natriuretic peptide progenitor (NT-proBNP) is a laboratory marker of heart failure (HF), associated with cardiovascular morbidity and mortality in the general population. Objectives: To measure NT-proBNP serum levels in SLE patients without HF signs before initiation of the therapy. To monitor NT-proBNP levels during therapy up to achieving SLE remission. Methods: The study included 15 patients (87% females, aged 31[29-33]years (median [interquartile range 25-75%]) with untreated SLE (ACR 1997 and SLICC 2012 criteria) without HF. These were patients with a new-onset and long-standing disease, who discontinued administered therapy. The control included 39 healthy donors (27[24-44]years, 87% females). A comprehensive SLE patients’ evaluation was made twice: at baseline and at the end of follow up (FUP), median FUP was 7[2-7]years. Serum levels of NT-proBNP (pg/ml) were measured using electrochemiluminescence method Elecsys proBNP II (Roche Diagnostics, Switzerland). Normal NT-proBNP levels should vary within ≤125pg/ml. Results: At enrollment medial SLE duration was 1[1-7]years, SLEDAI-2K - 10[8-20], SLICC/DI - 0[0-1]scores, SLE patients had elevated (vs controls) values of NT-proBNP: 150,7[77,6-550,2] vs 44,6[29,7-66,91]pg/ml, p 125pg/ml were found in 8(53%) SLE patients without HF. Glucocorticoids and hydroxychloroquine were initiated in all patients, and additionally cyclophosphamide was administered in 7(47%) patients, mycophenolate mofetil – in 10(67%), azathioprine – in 5(33%), rituximab – in 3(20%). By the end of FUP patients’ median age was 36[34-39]years p 0,05, with only one case (7%) with NT-proBNP level >125pg/ml. Median NT-proBNP concentration dropped from 150,7[77,6-550,2] to 26,6[19,3-64,9]pg/ml, р In “naive” to treatment SLE patients NT-proBNP levels showed positive correlation with concentrations of creatinine (r=0,614, p Conclusion: NT-proBNP concentrations in “untreated” SLE patients with high disease activity and without CV pathology and HF were significantly higher than in the control group (p 125pg/ml) baseline concentration. Elevated NT-proBNP concentrations were associated with markers renal function (creatinine, urea, GFR). Adequate immunosuppressive therapy resulted in achievement of SLE remission and normalization of NT-proBNP concentrations. Disclosure of Interests: None declared