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Establishment of brain natriuretic peptide ‐ based criteria for evaluating cardiac response to treatment in light chain (AL) amyloidosis
Author(s) -
Lilleness Brian,
Doros Gheorghe,
Ruberg Frederick L.,
Sanchorawala Vaishali
Publication year - 2020
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.16198
Subject(s) - medicine , al amyloidosis , brain natriuretic peptide , cardiac amyloidosis , amyloidosis , natriuretic peptide , cardiology , heart failure , immunoglobulin light chain , immunology , antibody
Summary Severity of cardiac involvement remains the leading determinant of survival in light chain (AL) amyloidosis. Until recently, cardiac response after treatment relied on reduction of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP). In this study, 94 patients with AL amyloidosis (baseline BNP ≥150 pg/ml) had BNP measured at 6 months following treatment. Median overall survival was not reached for cardiac response (≥50 pg/ml and ≥ 30% decrease in BNP), 9·2 years for cardiac stability (<50 pg/ml and <30% change in BNP) and 2·8 years for cardiac progression (≥50 pg/ml or ≥30% increase in BNP) (log‐rank P < 0·001). Cardiac response and progression, as measured by BNP values, are significantly associated with survival in AL amyloidosis.