N-terminal pro-brain natriuretic peptide and risk of cardiovascular events in older patients with type 2 diabetes: The Edinburgh type 2 diabetes study

Anna H. Price*, Paul Welsh, Christopher J. Weir, Insa Feinkohl, Christine M. Robertson, Joanne Morling, Stela McLachlan, Mark W.J. Strachan, Naveed Sattar, Jackie F. Price

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)2505-2512
Number of pages8
JournalDiabetologia
Volume57
Issue number12
DOIs
Publication statusPublished - Dec 2014
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Springer-Verlag Berlin Heidelberg 2014.

Keywords

  • Cardiovascular disease
  • Epidemiology
  • NT-proBNP
  • Risk prediction

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