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Pro-B-type natriuretic peptide strongly predicts cardiovascular mortality in coronary artery disease patients with type 2 diabetes

Session Poster session 6

Speaker Christoph Saely

Event : ESC Congress 2017

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : D Zanolin (Feldkirch,AT), P Rein (Feldkirch,AT), CH Saely (Triesen,LI), A Vonbank (Feldkirch,AT), C Lins (Feldkirch,AT), A Leiherer (Feldkirch,AT), A Schuler (Feldkirch,AT), P Schwerzler (Triesen,LI), A Mader (Triesen,LI), A Muendlein (Feldkirch,AT), H Drexel (Philadelphia,US)

Authors:
D. Zanolin1 , P. Rein2 , C.H. Saely3 , A. Vonbank2 , C. Lins1 , A. Leiherer1 , A. Schuler2 , P. Schwerzler3 , A. Mader3 , A. Muendlein1 , H. Drexel4 , 1VIVIT Institute - Feldkirch - Austria , 2Academic Teaching Hospital, Department of Medicine and Cardiology - Feldkirch - Austria , 3Private University of the Principality of Liechtenstein - Triesen - Liechtenstein , 4Drexel University College of Medicine - Philadelphia - United States of America ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 1127

Introduction: Elevated pro-B-type natriuretic peptide (proBNP) is associated with an increased risk of cardiovascular events in various populations including patients with type 2 diabetes (T2DM) and patients with coronary artery disease (CAD).

Purpose: The purpose of this study was to investigate the power of this biomarker to predict cardiovascular mortality in patients with the combination of T2DM and CAD.

Methods: We prospectively investigated a consecutive series of 591 patients with angiographically proven CAD over a mean follow-up period of 5.9±1.1 years.

Results: At baseline, proBNP was significantly higher in patients with T2DM (n=163; 27.6% of the study population) than in nondiabetic subjects (793±1249 vs. 685±1401 pg/ml; p=0.020). Prospectively, cardiovascular death occurred significantly more frequently in patients with T2DM than in nondiabetic subjects (14.1 vs. 6.3%; p=0.002) and cardiovascular death strongly increased over tertiles of proBNP in patients with T2DM (4.3%, 21.7%, and 73.9%, respectively; p=0.019) as well as in subjects without T2DM (11.1%, 14.8%, and 74.1%, respectively; p<0.001). Concordantly, serum proBNP significantly predicted cardiovascular mortality after adjustment for age, gender, smoking, LDL cholesterol, HDL cholesterol, hypertension, and eGFR both in patients with T2DM (standardized adjusted HR 2.36 [1.48–3.77]; p<0.001) and in those without T2DM (HR 1.59 [1.19–2.11]; p=0.002).

Conclusion: We conclude that serum proBNP strongly predicts cardiovascular mortality in CAD patients with T2DM as well as in nondiabetic CAD patients.

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