Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria |
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Authors: | P Gæde P Hildebrandt G Hess H-H Parving O Pedersen |
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Institution: | (1) Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark;(2) Frederiksberg Hospital, Copenhagen, Denmark;(3) Roche Diagnostics, Mannheim, Germany;(4) University of Mainz, Mainz, Germany;(5) Faculty of Health Science, University of Aarhus, Aarhus, Denmark |
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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. |
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Keywords: | Cardiovascular disease Heart failure Microalbuminuria Multifactorial intervention trial Natriuretic peptide Risk factors Type 2 diabetes |
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