THU0258 N-terminal pro-brain natriuretic peptide in a novel screening algorithm for pulmonary arterial hypertension in systemic sclerosis

Background Pulmonary Arterial Hypertension (PAH) is a major cause of mortality in SSc. N-terminal pro-brain natriuretic peptide (NT-proBNP) has emerged as a candidate biomarker that may enable the early detection of systemic sclerosis-related pulmonary arterial hypertension (SSc-PAH). Objectives To incorporate N-terminal pro-brain natriuretic peptide (NT-proBNP) into a screening algorithm for systemic sclerosis-related pulmonary arterial hypertension (SSc-PAH) that could potentially replace transthoracic echocardiography (TTE) as a less costly and more convenient “first tier” test. Methods NT-proBNP levels were measured in patients from 4 clinical groups: a group with right heart catheter (RHC) diagnosed SSc-PAH prior to commencement of therapy for PAH; a group at high risk of SSc-PAH based on TTE; a group with interstitial lung disease; and systemic sclerosis (SSc) controls with no cardiopulmonary complications. NT-proBNP levels were compared using ANOVA and correlated with other clinical variables using simple and multiple linear regression. ROC curve analyses were performed to determine the optimal cut-point for NT-proBNP and other clinical variables in prediction of PAH. Results NT-proBNP was highest in the PAH group compared to other groups (p