NT-proBNP as a predictor of death and cardiovascular events in patients with type 2 diabetes

Abstract

Existing risk prediction scores based on clinical and laboratory variables have been considered inaccurate in patients with Type 2 Diabetes Mellitus (T2DM). Circulating concentrations of natriuretic peptides have been used to aid in the diagnosis and to predict outcomes in heart failure. However, there is a growing body of evidence for the use of natriuretic peptides measurements, mainly N-terminal pro-B-type natriuretic peptide (NT-proBNP), as a tool in risk stratification for individuals with T2DM. Studies have demonstrated the ability of NT-proBNP to improve outcomes prediction when incorporated into multivariate models. More recently, evidence has emerged of the discriminatory power of NT-proBNP, demonstrating, as a single variable, a similar and even superior ability to multivariate risk models for the prediction of death and cardiovascular events in individuals with T2DM. Natriuretic peptides are synthesized and released from the myocardium as a counter-regulatory response to increased cardiac wall stress, sympathetic tone, and vasoconstriction, acting on various systems and affecting different biological processes. In this article, we present a review of the accumulated knowledge about these biomarkers, underscoring the strength of the evidence of their predictive ability for fatal and non-fatal outcomes. It is likely that, by influencing the functioning of many organs, these biomarkers integrate information from different systems. Although not yet recommended by guidelines, measurement of natriuretic peptides, and particularly NT-proBNP, should be strongly considered in the risk stratification of individuals with T2DM.

Natriuretic Peptide: Diagnostic, Prognostic, and Clinical Relevance in Patients With Type 2 Diabetes Mellitus, Arterial Hypertension and Obesity

“…Our results confirm the importance of determining NT-proBNP in patients with comorbid pathology, namely, AH in combination with Т2DM and obesity is a prognostically significant parameter of heart failure in this patient group. Our study is consistent with other authors who have studied the importance of NT-proBNP in the development of cardiovascular complications in patients with monopathology of AH, T2DM, and obesity [12][13][14][15][16][17][18].…”

The Lebanese Society of Cardiology Consensus Statement on the Use of Natriuretic Peptides for the Management of Heart Failure

“…NT-proBNP strongly predicts the first onset of HF and is confirmed by a me-World Journal of Cardiovascular Diseases ta-analysis from 40 studies published before 2014 that included 95,617 individuals without a history of cardiovascular disease [23]. In patients with type 2 diabetes hospitalized for HF, a sharp increase in NT-proBNP levels was noted 6 months preceding hospitalization [24].…”

Comparative study of Dapagliflozin versus Glimepiride effect on insulin regulated aminopeptidase (IRAP) and interleukin-34 (IL-34) in patient with type 2 diabetes mellitus

“…Although, until now, there is no recommendation by guidelines, NP have shown to be very powerful diagnostic and predictive tool for patients with type 2 diabetes mellitus to predict the risk of heart failure and other cardiovascular events. They can also be used for risk stratification in this population 15 , 17 .…”