N-terminal pro-brain natriuretic peptide and risk of cardiovascular events in older patients with type 2 diabetes: the Edinburgh Type 2 Diabetes Study

Price, A. H., Welsh, P. , Weir, C. J., Feinkohl, I., Robertson, C. M., Morling, J. R., McLachlan, S., Strachan, M. W. J., Sattar, N. and Price, J. F. (2014) N-terminal pro-brain natriuretic peptide and risk of cardiovascular events in older patients with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetologia, 57(12), pp. 2505-2512. (doi:10.1007/s00125-014-3375-9)

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Publisher's URL: http://dx.doi.org/10.1007/s00125-014-3375-9

Abstract

Aims/hypothesis The aim of this study was to investigate the association of N-terminal pro-brain natriuretic peptide (NT-proBNP) with traditional cardiovascular risk factors and incident cardiovascular events in older people with type 2 diabetes.

Methods In the prospective phase of the Edinburgh Type 2 Diabetes Study, 1066 men and women aged 60 to 75 years with type 2 diabetes mellitus were followed for 4 years; 112 participants had an incident cardiovascular event. At baseline, cardiovascular risk factors, pre-existing cardiovascular disease and levels of NT-proBNP were evaluated.

Results Raised plasma NT-proBNP levels were associated with these classical cardiovascular risk factors: increased duration of diabetes, use of insulin, raised BMI, reduced HDL-cholesterol, reduced renal function and use of lipid-lowering and anti-hypertensive medication (all p < 0.05). In the prospective analysis, NT-proBNP was strongly associated with subsequent risk of all cardiovascular disease events (HR per one SD increase in NT-proBNP 1.39; 95% CI 1.10, 1.75), independent of cardiovascular risk factors traditionally used to predict vascular events. NT-proBNP was also independently associated with incident coronary artery disease events (1.48, 95% CI 1.10, 1.98). The addition of NT-proBNP to multivariate models improved the C-index by 0.019 for the ‘hard’ cardiac endpoint (fatal and non-fatal myocardial infarction).

Conclusions/interpretation In older people with type 2 diabetes, NT-proBNP is associated with the development of coronary and cerebrovascular events, independent of a wide range of other vascular and metabolic risk factors, and may prove a useful addition to current vascular risk scores in diabetes populations.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Weir, Christopher and Welsh, Dr Paul and Sattar, Professor Naveed
Authors: Price, A. H., Welsh, P., Weir, C. J., Feinkohl, I., Robertson, C. M., Morling, J. R., McLachlan, S., Strachan, M. W. J., Sattar, N., and Price, J. F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Diabetologia
Publisher:Springer-Verlag
ISSN:0012-186X
ISSN (Online):1432-0428
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