NH-proBNP Strongly Predicts Cardiac Mortality in T2DM
Increased risk also seen in patients with only slightly elevated levels and without preexisting CV disease
THURSDAY, April 18 (HealthDay News) -- NH2-terminal probrain natriuretic peptide (NT-proBNP) predicts the risk of cardiovascular (CV) mortality in patients with type 2 diabetes without previous CV disease (CVD), according to a study published online April 5 in Diabetes Care.
Graziella Bruno, M.D., from University of Turin in Italy, and colleagues examined the value of NT-proBNP for predicting mortality for 1,825 patients with type 2 diabetes from a population-based cohort. At baseline, CV risk factors, preexisting CVD, and NT-proBNP levels were assessed, and all-cause and CV mortality were evaluated 5.5 years later.
The researchers found that 390 people died (175 from CVD) during the follow-up period. There was a significantly increased risk of mortality observed by quartiles of NT-proBNP. For values of NT-proBNP > 91 pg/mL, the hazard ratios for all-cause and CV mortality were 2.05 and 4.47, respectively. This finding was independent of CV risk factors, including C-reactive protein (CRP) and albumin excretion rate (AER). For patients with modest increases in NT-proBNP levels and for those without microalbuminuria and CVD at baseline, the association was significant (upper quartiles hazard ratios, 3.82 and 3.14, respectively). There was an additive effect on mortality seen for albuminuria and NT-proBNP, though the correlation was stronger for NT-proBNP.
"NT-proBNP is a strong independent predictor of short-term CV mortality risk in elderly people with type 2 diabetes, including those without preexisting CVD," write the authors. "This association is evident even in people with slightly increased values, is not modified by CRP, and is additive to that provided by AER."