Plasma N-terminal pro-B-type natriuretic peptide and mortality in type 2 diabetes

Tarnow, Lise; Gall, M A; Hansen, Birgitte V.; Hovind, Peter; Parving, Hans‐Henrik

doi:10.1007/s00125-006-0359-4

Cited by 96 publications

(93 citation statements)

References 34 publications

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“…This finding may seem at odds with the reported data in the literature and in particular with the only known to us study on mortality risk, which was performed in type 2 diabetic patients (26).…”

Section: Discussioncontrasting

confidence: 80%

“…One limitation of our study was not to have investigated a subclinical left ventricular hypertrophy or ischemic coronary disease (28,29). However, also the above-mentioned study of Tarnow et al (26) did not carry out investigations beyond at resting electrocardiogram which has a notoriously low sensitivity.. However, since BPN has a strong prognostic power, an abnormal value of it could be the reason for starting with a more accurate heart diagnostic evaluation.…”

Section: Discussionmentioning

confidence: 99%

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

Faglia¹,

Clerici²,

Caminiti³

et al. 2013

DIAB

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The background of this article is to retrospectively investigate the role of B-type natriuretic peptide (BNP) levels as an independent prognostic marker for mortality in diabetic patients with foot ulcer.In the period 1 January-30 June 2009, 279 diabetic patients were admitted to our foot center because of foot ulcer: neuroischemic in 182 (65.2%), neuropathic in 97 (34.8%), infected in 233 (83.5%). In all patients BNP (normal value: ≤ 100 pg/mL) was evaluated at admission.Mortality from any cause was established and the relationship between the recorded variables and risk of death was evaluated by the survival Cox regression model. Kaplan-Meier analysis was performed. BNP was >100 pg/mL in 167 (59.9%) patients. 278 (99.6%) patients were followed to December 31, 2012 with a mean follow-up of 3.6 ± 0.2 years.Seventy-one/278 (25.5%) patients died. Of these, 61 (85.9%) had a BNP value >100 pg/mL. Forty-five/71 (63.4%) patients died from cardiac cause. The most frequent cause of death was heart disease: 45/71 (63.4%). Of these, 24 patients had no history of CAD.Multivariate analysis showed the independent predictors of death to be BNP > 100 (hazard ratio 6.040; p <0.001; CI, 2.380-15.328), age (hazard ratio 1.043, p = 0.024, CI 1.001-1.082), and dialysis treatment (hazard ratio 3.145; p = 0.032; CI, 1.100-8.988).

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Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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

Faglia¹,

Clerici²,

Caminiti³

et al. 2013

DIAB

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“…The prognostic information provided appears to be incremental to that derived from established risk factors. There are, however, relatively few data assessing the ability of BNP and NT-proBNP to predict cardiovascular outcomes in patients with type 2 diabetes (14,15) and no prior studies that assess the ability of these markers to reclassify the risk of individual patients.…”

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confidence: 99%

The Relative and Combined Ability of High-Sensitivity Cardiac Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide to Predict Cardiovascular Events and Death in Patients With Type 2 Diabetes

et al. 2013

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OBJECTIVECurrent methods of risk stratification in patients with type 2 diabetes are suboptimal. The current study assesses the ability of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) to improve the prediction of cardiovascular events and death in patients with type 2 diabetes. RESEARCH DESIGN AND METHODSA nested case-cohort study was performed in 3,862 patients who participated in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. RESULTSSeven hundred nine (18%) patients experienced a major cardiovascular event (composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) and 706 (18%) died during a median of 5 years of follow-up. In Cox regression models, adjusting for all established risk predictors, the hazard ratio for cardiovascular events for NT-proBNP was 1.95 per 1 SD increase (95% CI 1.72, 2.20) and the hazard ratio for hs-cTnT was 1.50 per 1 SD increase (95% CI 1.36, 1.65). The hazard ratios for death were 1.97 (95% CI 1.73, 2.24) and 1.52 (95% CI 1.37, 1.67), respectively. The addition of either marker improved 5-year risk classification for cardiovascular events (net reclassification index in continuous model, 39% for NTproBNP and 46% for hs-cTnT). Likewise, both markers greatly improved the accuracy with which the 5-year risk of death was predicted. The combination of both markers provided optimal risk discrimination. CONCLUSIONSNT-proBNP and hs-cTnT appear to greatly improve the accuracy with which the risk of cardiovascular events or death can be estimated in patients with type 2 diabetes.

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“…Others have found, however, that NT-proBNP also strongly predicts all-cause and CVD-related mortality in individuals with type 2 diabetes mellitus. 26 Several previous studies have found that higher levels of NT-proBNP predict cardiovascular events in patients with heart failure, in older individuals, and in patients on dialy- Adjusted RH of any cardiovascular event, by NTproBNP category for selected subgroups (adjusted for age, sex, baseline GFR, systolic and diastolic blood pressure, urinary sodium-potassium ratio, non-HDL cholesterol, abnormal ECG, body mass index, and randomization group assignment). †Pro-teinuria defined as urinary protein-creatinine ratio Ͼ0.22.…”

Section: Discussionmentioning

confidence: 99%

N-Terminal Prohormone Brain Natriuretic Peptide as a Predictor of Cardiovascular Disease and Mortality in Blacks With Hypertensive Kidney Disease

Astor

Hiremath

et al. 2008

Circulation

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Background-Higher levels of N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) predict cardiovascular disease (CVD) in several disease states, but few data are available in patients with chronic kidney disease or in blacks. Methods and Results-The African American Study of Kidney Disease and Hypertension trial enrolled hypertensive blacks with a glomerular filtration rate of 20 to 65 mL · min Ϫ1 · 1.73 m Ϫ2 and no other identified cause of kidney disease. NT-proBNP was measured with a sandwich chemiluminescence immunoassay (coefficient of variation 2.9%) in 994 African American Study of Kidney Disease and Hypertension participants. NT-proBNP was categorized as undetectable, low, moderate, or high. Proteinuria was defined as 24-hour urinary protein-creatinine ratio Ͼ0.22. A total of 134 first CVD events (CVD death or hospitalization for coronary artery disease, heart failure, or stroke) occurred over a median of 4.3 years. Participants with high NT-proBNP were much more likely to have a CVD event than participants with undetectable NT-proBNP after adjustment (relative hazard 4.0 [95% confidence interval [CI] 2.1 to 7.6]). A doubling of NT-proBNP was associated with a relative hazard of 1.3 (95% CI 1.0 to 1.6) for coronary artery disease, 1.7 (95% CI 1.4 to 2.2) for heart failure, 1.1 (95% CI 0.9 to 1.4) for stroke, and 1.8 (95% CI 1.4 to 2.4) for CVD death. The association of NT-proBNP with CVD events was significantly stronger (P interaction ϭ0.05) in participants with than in those without proteinuria. Higher NT-proBNP was not associated with renal disease progression. Conclusions-These results suggest that elevated NT-proBNP levels are associated with higher CVD risk among blacks with hypertensive kidney disease. This association may be stronger in individuals with significant proteinuria.

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Plasma N-terminal pro-B-type natriuretic peptide and mortality in type 2 diabetes

Cited by 96 publications

References 34 publications

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

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

The Relative and Combined Ability of High-Sensitivity Cardiac Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide to Predict Cardiovascular Events and Death in Patients With Type 2 Diabetes

N-Terminal Prohormone Brain Natriuretic Peptide as a Predictor of Cardiovascular Disease and Mortality in Blacks With Hypertensive Kidney Disease

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