2026-04-18T05:41:21Zhttps://recercat.cat/oai/request

oai:recercat.cat:10459.1/4696672026-03-02T19:39:56Zcom_2072_3622col_2072_479130

Can NT-proBNP Enhance the Accuracy of Angiogenic Factors in the Short-Term Prediction of Preeclampsia? Garrido Giménez, Carmen Nan, Madalina Nicoleta Cruz Lemini, Mónica García Manau, Pablo Garcia Osuna, Álvaro Ullmo, Johana Mora, Josefina Sánchez García, Olga Medina Mallén, Maria Del Carmen Chóliz, Marta Platero, Judit Llurba, Elisa Pelegay Escartín, Maria José Background Angiogenic biomarkers aid in short-term prediction of preeclampsia (PE) but are often limited by false-positive results. N-terminal pro–B-type natriuretic peptide (NT-proBNP), which is elevated in PE due to cardiovascular dysfunction, may enhance diagnostic precision. This study evaluated whether adding NT-proBNP to the soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio improves prediction of PE and associated complications within 1 week. Methods We performed a prospective multicenter case-control study in pregnancies with suspected PE between 24 + 0 and 41 + 0 weeks. Three models evaluated the addition of NT-proBNP (cutoff ≥116 pg/mL) to the sFlt-1/PlGF ratio using thresholds <38, ≥85, and 38 to 84. All models were assessed for early-onset, preterm, term, and overall PE prediction using receiver operating curve analysis, predictive metrics, and Kaplan–Meier survival curves. Results A total of 316 women (424 serum samples) were included. PE occurred in 23.4% of cases, including 8.5% early-onset PE. NT-proBNP levels were significantly elevated in PE cases. The addition of NT-proBNP improved early-onset PE prediction, particularly in intermediate-risk cases (sFlt-1/PlGF 38–84), achieving an area under the curve (AUC) of 0.949 and a negative predictive value (NPV) of 99.5%, outperforming sFlt-1/PlGF alone. Survival analysis revealed a shorter median time to delivery when both biomarkers were elevated (1.3 vs 4.0 weeks; P < 0.001). For term PE, NT-proBNP increased positive predictive value when combined with sFlt-1/PlGF ≥ 38. In complicated PE, the combined model improved specificity (77.4%) and AUC (0.770), with an NPV of 91.1%. Conclusions NT-proBNP enhances the short-term predictive performance of the sFlt-1/PlGF ratio, particularly in intermediate-risk cases. This multimarker approach may refine risk stratification and support timely clinical intervention in pregnancies at risk of PE. 2026-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://doi.org/10.1093/clinchem/hvaf135 1530-8561 https://hdl.handle.net/10459.1/469667 https://hdl.handle.net/10459.1/469667 eng Reproducció del document publicat a https://doi.org/10.1093/clinchem/hvaf135 Clinical Chemistry, 2026, vol. 72, núm. 1, p. 206-216 cc-by-nc-nd, (c) Carmen Garrido Giménez et al., 2026 Attribution-NonCommercial-NoDerivatives 4.0 International info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by-nc-nd/4.0/ Oxford University Press