Author + information
- Mina Nakayama,
- Megumi Yamamuro,
- Yohei Hanajima,
- Yuichi Okajima,
- Naoki Nakayama,
- Toru Dejima,
- Masahiko Kanna,
- Yukiko Morita,
- Kenichi Tsujita and
- Kazuo Kimura
Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis associated with bronchial asthma and hypereosinophilia. There were few reports specialized in cardiac involvement, and there have been no study investigated the importance of B-type natriuretic peptide (BNP) for the prognosis in EGPA patients.
Methods: We evaluated 120 EGPA patients who had cardiac involvement (CI group; n=42, 35%) or not (no CI group; n=78, 65%). We surveyed long-term prognosis and prognostic factors.
Results: During 4 years of median follow-up period, 10 patients died. Among them, 4 patients died due to cardiovascular events (heart failure; n=3, myocarditis; n=1). Nine patients were hospitalized by the cardiac events unexpectedly. Survival rate at 4 years was 83.3% in the CI group, and 94.9% in the no CI group. In Kaplan-Meier curve, there were no significant differences in all-cause mortality (log-rank test P=0.062) and cardiovascular death (log-rank test P=0.11) between the two groups. Unexpected hospitalization due to cardiac events were more frequently in the CI group (log-rank test P=0.001). In multivariate cox regression analysis, logarithm (Log) B-type natriuretic peptide (BNP) levels was significantly associated with all-cause mortality (Log BNP: hazard ratio (HR) 5.64, P=0.004, 95%CI: 1.76-18.09) and cardiovascular death (HR 7.59, P=0.04, 95%CI: 1.09-52.68). Log BNP levels at stable condition with a cut off of 1.96 (BNP: 91 pg/mL) had 80% sensitivity and 93% specificity in all-cause mortality (area under the curve (AUC) =0.88, 95%CI: 0.755-1.00). Log BNP levels at stable condition with a cut off of 2.24 (BNP: 173 pg/mL) had 75% sensitivity and 95% specificity in cardiovascular death (area under the curve (AUC) =0.90, 95%CI: 0.769-1.00).
Conclusions: In EGPA patients, cardiac involvement was associated with unexpected hospitalization for cardiac events, whereas it was not associated with all-cause mortality and cardiovascular death. BNP levels at stable condition was an useful marker to predict all-cause mortality and cardiovascular death in EGPA patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-284
- 2017 American College of Cardiology Foundation