High circulating N-terminal pro-brain natriuretic peptide and tumor necrosis factor-α in mixed cryoglobulinemia

AIM： To evaluate serum levels of N-terminal pro-brain natriuretic peptide （NTproBNP） and tumor necrosis factor α （TNF-α） in a large series of patients with hepatitis C associated with mixed cryoglobulinemia （MC＋HCV）.METHODS： Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC＋HCV, and in 50 sex- and age-matched controls. RESULTS： Cryoglobulinemic patients showed signifi cantly higher mean NTproBNP and TNF-α levels than controls （P 〈 0.001; Mann-Whitney U test）. By defining high NTproBNP level as a value higher than 125 pg/mL （the single cut-off point for outpatients under 75 years of age）, 30% of MC＋HCV and 6% of controls had high NTproBNP （χ2, P 〈 0.01）. With a cut-off point of 300 pg/mL （used to rule out heart failure （HF） in patients under 75 years of age）, 8% of MC＋HCV and 0 controls had high NTproBNP （χ2, P 〈 0.04）. With a cut-off point of 900 pg/mL （used for ruling in HF in patients aged 50-75 years; such as thepatients of our study）, 6% of MC＋HCV and 0 controls had high NTproBNP （χ2, P = 0.08）.CONCLUSION： The study demonstrates high levels of circulating NTproBNP and TNF-α in MC＋HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.