CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2022; 130(04): 229-236
DOI: 10.1055/a-1540-5009

Serum NT-pro-BNP Levels Predict Cardiovascular Events in Acromegaly Patients

Marta Ragonese
1   Department of Human Pathology DETEV, University of Messina, Messina, Italy
Gianluca Di Bella
2   Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
Federica Spagnolo
3   Unit of Endocrinology, University of Messina, Messina, Italy
Loredana Grasso
4   Service of Immunometry and Laboratory Diagnosis, University Hospital “G. Martino”, Messina, Italy
Angela Alibrandi
5   Department of Economics, University of Messina, Messina, Italy
Guiseppe Giuffrida
2   Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
Mariacarla Moleti
2   Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
Francesco Ferraù
1   Department of Human Pathology DETEV, University of Messina, Messina, Italy
Salvatore Cannavò
1   Department of Human Pathology DETEV, University of Messina, Messina, Italy
› Author Affiliations
Funding The study was supported by the project PRIN 2015 (number 2015ZHKFTA) of the Italian Ministry of Education, University and Research, through research grants.


Background Acromegaly is associated with an increased risk of fatal and non-fatal cardiovascular (CV) events. Controlling acromegaly decreases, but does not normalize this risk. Brain natriuretic peptide (BNP) assessment is used in the general population for the diagnosis of heart failure and to predict ischemic recurrences and mortality. This is a retrospective, longitudinal, monocenter study that evaluates the role of serum N-terminal fragment of BNP (NT-pro-BNP) for predicting CV events in acromegaly patients.

Methods Serum NT-pro-BNP levels were measured in 76 patients with acromegaly (23 males, 57.7±1.5 years), and compared with other predictors of CV events. NT-pro-BNP cut-off value discriminating the occurrence of CV events was determined by ROC analysis. CV events were recorded during a follow-up of 78.6±6.4 months.

Results CV events occurred in 9.2% of patients. Mean log(NT-pro-BNP) concentration was higher in patients who experienced CV events than in those who did not (p<0.01) and in patients who died due to CV events than in those who died due to other causes (p<0.01). Based on the ROC curve, a cut-off value of 91.55 pg/mL could predict CV events (OR 19.06). Log(NT-pro-BNP) was lower in surgically treated patients by surgery (p<0.05), and in those cured by neurosurgery (p<0.02).

Conclusions High NT-pro-BNP value is an independent middle-term predictor of fatal or non-fatal CV events in patients with acromegaly. According to this parameter, surgically treated patients show lower CV risk than those managed with medical therapy, especially if the disease is cured.

Publication History

Article published online:
23 December 2021

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