Plasma B-Type Natriuretic Peptide Is Useful for Cardiovascular Risk Assessment in Community-Based Diabetes Subjects

Abstract

SummaryDiabetes mellitus (DM) is a strong risk factor for cardiovascular (CV) disease. Plasma B-type natriuretic peptide (BNP) levels are elevated in various types of cardiac diseases. Increased plasma BNP levels have been reported to be associated with CV risk in apparently healthy individuals. However, no studies have yet examined the specific value of plasma BNP for predicting CV incidence in unselected DM subjects in a community-based population.In a community-based DM cohort (n = 1,059, mean = 66 years), baseline BNP levels were determined, and CV events were followed and captured prospectively. The cohort was divided by plasma BNP quintiles. The Cox proportional hazard model was used to determine the relative hazard ratios (HR) among the quintiles. In addition, the effects of adding the plasma BNP or urine albumin-to-creatinine ratio (UACR) to an established CV risk scoring model was examined by calculating the area under the receiver operating characteristic (ROC) curve (AUC).During the 5.7 year follow-up period, CV events were identified in 65 of the DM cohort. There was a significant association between plasma BNP levels and CV event rate (P < 0.001). HR was significantly increased in the highest quintile compared to the lowest (HR = 4.38; 95%CI 1.69 -11.84). The AUC generated from ROC analysis of the Framingham risk score for predicting general CV events was improved by adding BNP testing (from 0.66 to 0.74; P = 0.05), but not by adding UACR (from 0.66 to 0.67; P = 0.49).In a community sample of people with DM, plasma BNP levels above the 80 percentile are directly associated with CV risk, and measurement of plasma BNP alone or in conjunction with an established CV risk score is of value in predicting CV events in these subjects. (Int Heart J 2012; 53: 176-181)

Increased B-type natriuretic peptide levels in early-onset versus late-onset preeclampsia

“…In asymptomatic type 2 diabetes patients BNP is related to diastolic dysfunction whereas urinary albumin excretion rate is related to left ventricular mass [27]. Onodera et al found plasma BNP levels more useful for cardiovascular risk assessment in diabetes mellitus patients compared to albuminuria [28]. Meanwhile, Leeuw et al found in patients with severe burns, that increased BNP level together with decreased proteinuria is associated with a better outcome.…”

B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

“…Plasma B-type natriuretic peptide (BNP) releases from the ventricles in response to hemodynamic stress, and BNP is one of the predictive markers for cardiovascular events [3,4].Among patients with type 2 diabetes mellitus, sev- Abstract. Among patients with type 2 diabetes mellitus, the association between B-type natriuretic peptide (BNP) and renal function remains controversial.…”

“…Plasma B-type natriuretic peptide (BNP) releases from the ventricles in response to hemodynamic stress, and BNP is one of the predictive markers for cardiovascular events [3,4].…”

B-Type Natriuretic Peptide Predict Mortality in Diabetic Patients with Foot Ulcer

“…Very recently a number of studies have investigated the value of BNP in diabetes disease (20)(21)(22)(23)(24) but role of BNP in the prognosis of diabetic patients with foot ulcer has not been examined except after the use of hyperbaric oxygen therapy (25). This study has shown that patients with BNP > 100 pg/mL mg/dl have a higher risk of all-cause mortality in patients with foot ulcer.…”