Joachim Moecks

N-Terminal Pro–B-Type Natriuretic Peptide Concentrations Predict the Risk of Cardiovascular Adverse Events from Antiinflammatory Drugs: A Pilot Trial

BACKGROUND we investigated whether higher concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) predicts cardiovascular adverse events (CV-AEs) in patients with osteoarthritis treated with antiinflammatory drugs. METHODS NT-proBNP was measured in baseline samples from 433 patients enrolled in a prospective randomized study designed to test the therapeutic effect of a novel metalloproteinase inhibitor. We monitored CV-AEs and retrospectively investigated their relationship to the concomitant use of selective cyclooxygenase-2 inhibitors (coxibs), traditional nonsteroidal antiinflammatory drugs (tNSAIDs), and glucocorticoids. CV-AEs included myocardial infarction, stroke, new or worsening of preexisting arterial hypertension, congestive heart failure, and several less severe CV-AEs. RESULTS we observed 82 mild to serious CV-AEs during an observational period of 200 days. The risk of such events was 1.95-fold higher in patients who were taking tNSAIDs, glucocorticoids, or coxibs (i.e., any inhibitor) and who had NT-proBNP concentrations > or = 100 ng/L than in patients taking any inhibitor who had NT-proBNP values <100 ng/L (P < 0.05). Patients taking coxibs (alone or in addition to tNSAIDs or glucocorticoids) with baseline NT-proBNP values > or = 100 ng/L had a 7.41-fold higher risk for CV-AEs than those with baseline values <100 ng/L (P < 0.01). Patients who were taking 2 or more antiinflammatory drugs and had NT-proBNP values > or = 100 ng/L had a 3.74-fold higher risk for CV-AEs than those with NT-proBNP values <100 ng/L (P < 0.05). An NT-proBNP value <100 ng/L was associated with negative predictive values of >85% across all treatment groups. CONCLUSIONS NT-proBNP may be a useful marker for anticipating cardiovascular risk associated with the use of antiinflammatory drugs for osteoarthritis.

Progress in diagnostic pattern recognition (DPR)

The identification and analysis of disease-specific signatures in mid-infrared spectra of serum forms the basis of a method called “Diagnostic Pattern Recognition (DPR)”. A conceivable usage of this method in clinical diagnostics requires that the method be applied in a convenient and robust manner. Thus, automation, room-temperature operation and reproducibility the prerequisite improvements toward routine application. We have investigated the performance two identical, semi-automated DPR systems. In contrast to previous measurements, which required MCT detectors, the use of a DLaTGS detector allowed the systems to be operated without the requirement of liquid nitrogen cooling. A series of measurements showed that automated pipetting improves the reproducibility significantly as compared to manual pipetting. For automated pipetting, the within-day variations are of minor importance. However, day-to-day variations may decrease the reproducibility in some spectral regions by more than a factor of two. Slight dependence of the reproducibility on the protein content of the serum samples has been observed.