Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria

Diabetologia. 2005 Jan;48(1):156-63. doi: 10.1007/s00125-004-1607-0. Epub 2004 Dec 24.

Abstract

Aims/hypothesis: We examined whether plasma N-terminal probrain natriuretic peptide (NT-proBNP) predicts cardiovascular outcome in patients with type 2 diabetes.

Methods: A total of 160 microalbuminuric type 2 diabetic patients (mean age 55.1 years [SD 7.2], 119 men) were enrolled in the Steno-2 Study examining the effect of multifactorial treatment, and were divided into two groups according to baseline levels of plasma NT-proBNP below or above the median for the cohort, which was followed for an average of 7.8 years. Cardiovascular outcome was a composite of cardiovascular mortality, myocardial infarction, stroke, revascularisation procedures in the heart or legs, and amputations.

Results: In the whole group, plasma NT-proBNP being above the median was associated with an increased risk of cardiovascular disease during follow-up, with an unadjusted hazard ratio of 4.4 (95% CI 2.3-8.4; p<0.0001). A decrease in plasma NT-proBNP of 10 pg/ml during the first 2 years of intervention was associated with a 1% relative reduction in the primary endpoint (p<0.001). Despite polypharmacological treatment targeting cardiovascular disease, the mean plasma NT-proBNP level increased during follow-up.

Conclusions/interpretation: We conclude that high plasma NT-proBNP is a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria.

MeSH terms

  • Albuminuria / blood
  • Biomarkers / blood*
  • Blood Pressure
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Angiopathies / epidemiology*
  • Diabetic Angiopathies / mortality*
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain
  • Nerve Tissue Proteins / blood*
  • Peptide Fragments / blood*
  • Proportional Hazards Models
  • Smoking
  • Time Factors

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Nerve Tissue Proteins
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain