Key result
Beta-thalassemia major is linked to markedly higher NT-proBNP levels compared to healthy controls.
Why the study?
Patients with beta-thalassemia major are prone to cardiovascular complications, making early identification of at-risk patients important.
Are B-type natriuretic peptide levels elevated in patients with beta-thalassemia major compared to healthy controls?
Meta-Analysis
Are B-type natriuretic peptide levels elevated in patients with beta-thalassemia major compared to healthy controls?
Standardized Mean Difference: 1.37 (95% CI 0.856–1.893)
p-value: p=<0.001
B-type natriuretic peptides are significantly elevated in patients with beta-thalassemia major and correlate with markers of cardiac dysfunction, highlighting their potential utility as early markers of myocardial stress.
May support natriuretic peptide monitoring for early cardiac stress in beta-thalassemia major; confirms elevation but leaves clinical adoption open.
Background Patients with beta‐thalassemia major are prone for developing cardiovascular complications. Early identification of patients at risk is important. B‐type natriuretic peptides such as brain natriuretic peptide (BNP) and N‐terminal pro‐BNP (NT‐proBNP) are sensitive indicators of cardiac dysfunction. This review synthesizes the existing evidence on the levels of B‐type natriuretic peptides in beta‐thalassemia major and their relationship with markers of cardiac dysfunction and other biomarkers. Methods A systematic review was conducted according to PRISMA guidelines. The search was performed in the PubMed, Web of Science, ScienceDirect, and World Health Organization Virtual Health Library Regional Portal. Pooled standardized mean differences (SMD) and correlation coefficients ( r ) with 95% confidence intervals (CI) were calculated to investigate the differences in B‐type natriuretic peptides values and their relationships with various biomarkers in beta‐thalassemia major. Results A total of 29 studies were selected for the systematic review. Of them, 27 were included in the meta‐analyses. Most of the included studies focused on investigating NT‐proBNP. The analyses revealed significantly higher NT‐proBNP and BNP values in patients with beta‐thalassemia major compared to healthy controls. For NT‐proBNP, the pooled effect size (SMD) was 1.37 (95% CI: 0.856–1.893, p < 0.001), and for BNP, it was 1.94 (95% CI: 0.665–3.220, p = 0.003). Meta‐analyses of correlations revealed that NT‐proBNP was significantly correlated with serum ferritin levels ( r = 0.471, p = 0.006), E/E′ ratio ( r = 0.528, p < 0.001), and patients age ( r = 0.259, p = 0.004). Conclusion This systematic review provides evidence that beta‐thalassemia is associated with high levels of B‐type natriuretic peptides, which highlight the high risk of cardiovascular complications in this patient population. The significantly elevated levels of both molecules and their identified correlations emphasize clinical utility of them as markers of early myocardial stress and subclinical heart disease in beta‐thalassemia.
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Salih et al. (2025) conducted a meta-analysis in Beta-thalassemia major. Beta-thalassemia major vs. Healthy controls was evaluated on NT-proBNP levels (SMD 1.37, 95% CI 0.856-1.893, p=<0.001). Patients with beta-thalassemia major had significantly higher NT-proBNP levels compared to healthy controls (SMD 1.37; 95% CI 0.856-1.893; p<0.001).
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