2 research outputs found
N-terminal pro-B-type natriuretic peptide by itself predicts death and cardiovascular events in high-risk patients with type 2 diabetes
Background:
NTâproBNP (Nâterminal proâBâtype natriuretic peptide) improves the discriminatory ability of riskâprediction models in type 2 diabetes mellitus (T2DM) but is not yet used in clinical practice. We assessed the discriminatory strength of NTâproBNP by itself for death and cardiovascular events in highârisk patients with T2DM.
Methods and Results:
Cox proportional hazards were used to create a base model formed by 20 variables. The discriminatory ability of the base model was compared with that of NTâproBNP alone and with NTâproBNP added, using Câstatistics. We studied 5509 patients (with complete data) of 8561 patients with T2DM and cardiovascular and/or chronic kidney disease who were enrolled in the ALTITUDE (Aliskiren in Type 2 Diabetes Using Cardiorenal Endpoints) trial. During a median 2.6âyear followâup period, 469 patients died and 768 had a cardiovascular composite outcome (cardiovascular death, resuscitated cardiac arrest, nonfatal myocardial infarction, stroke, or heart failure hospitalization). NTâproBNP alone was as discriminatory as the base model for predicting death (Câstatistic, 0.745 versus 0.744, P=0.95) and the cardiovascular composite outcome (Câstatistic, 0.723 versus 0.731, P=0.37). When NTâproBNP was added, it increased the predictive ability of the base model for death (Câstatistic, 0.779 versus 0.744, P<0.001) and for cardiovascular composite outcome (Câstatistic, 0.763 versus 0.731, P<0.001).
Conclusions:
In highârisk patients with T2DM, NTâproBNP by itself demonstrated discriminatory ability similar to a multivariable model in predicting both death and cardiovascular events and should be considered for risk stratification