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Abstract Aims B-type natriuretic peptide (BNP) has been suggested to improve risk prediction of cardiovascular (CV) events and mortality. We aimed to evaluate the value of BNP to predict the composite primary endpoint of CV events and mortality alongside traditional and HIV specific risk factors in a HIV-infected population. Methods In this prospective multicenter HIV-HEART study we followed 808 HIV-positive subjects in the German Ruhr area for a median follow up of 120 (IQR:113–129) months since 2004. Association of BNP with the composite primary endpoint was assessed using Cox regression adjusting for traditional cardiovascular and HIV specific risk factors. Results At baseline, median BNP was 10.3 (IQR 5.4–18.9) pg/ml. The composite endpoint occurred in 158 (19.6%) patients. Subjects with high BNP levels showed significantly increased frequencies of CV events and death (22% for BNP ≤5 pg/ml, 30% for BNP >5 up to ≤20 pg ml, 38% for BNP >20 up to ≤35 pg ml, 59% for BNP >35 up to ≤100 pg ml and 86% for BNP >100 pg/ml, p-value < 0.01). In the fully adjusted model that included traditional CV risks as well as HIV specific factors, after a log 2 transformation, doubling of BNP was significantly associated with increased risk for the composite endpoint (HR:1.16 (95%CI 1.01–1.33); p = 0.031). Comparing BNP of <5 pg/ml to BNP > 100 pg/ml, HR in the fully adjusted model was 3.25 (95%CI 1.50–7.08; p < 0.001). Conclusions Increased BNP is associated with significant excess of incident CV events and mortality in HIV-infected patients. BNP is a valuable marker to improve the prediction of CV events and mortality. Highlights • Elevated levels of BNP are associated with significant excess of incident cardiovascular events and mortality in HIV-infected patients. • BNP improves the prediction of CVE and mortality in HIV-infected patients in addition to traditional risk factors and HIV specific parameters. • Elevated BNP in HIV-infected patients may be a useful marker for risk stratification of CVD to intensify risk management and to predict mortality. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The aim of this study was to compare the diagnostic accuracy of fully diagnostic, contrast-enhanced whole-body FDG-PET/CT and whole-body MRI for detection of bone metastases in patients suffering from newly diagnosed non-small cell lung cancer and malignant melanoma. Material and Methods: 109 consecutive non-small cell lung cancer (n =54) and malignant melanoma (n =55) patients underwent whole-body FDG-PET/CT and whole-body MRI for initial tumor staging. All images were evaluated by four experienced physicians (three radiologists, one nuclear medicine physician). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of bone metastases were determined for both modalities. Statistically significant differences between FDG-PET/CT and MRI were calculated with Fisher''s Exact test (p <0.05). Clinical and imaging follow-up data with a mean follow-up time of 434 days served as the reference standard. Results: According to the reference standard 11 patients (10%) suffered from bone metastases. The sensitivity, specificity, PPV, NPV, and accuracy for the detection of osseous metastases was 45%, 99%, 83%, 94%, and 94% with whole-body FDG-PET/CT and 64%, 94%, 54%, 96%, and 91% with whole-body MRI. The difference was not statistically significant (p =0.6147). Conclusions: FDG-PET/CT and MRI seem to be equally suitable for the detection of skeletal metastases in patients suffering from newly diagnosed non-small cell lung cancer and malignant melanoma. Both modalities go along with a substantial rate of false-negative findings requiring a close follow-up of patients who are staged free of bone metastases at initial staging. [Copyright &y& Elsevier]