A comparison of NT-proBNP and albuminuria for predicting cardiac events in patients with diabetes mellitus

@article{Clodi2012ACO,
  title={A comparison of NT-proBNP and albuminuria for predicting cardiac events in patients with diabetes mellitus},
  author={Martin Clodi and Michael Resl and Stephanie Neuhold and Martin H{\"u}lsmann and Greisa Vila and Marie Elhenicky and Guido Strunk and Heidemarie Abrahamian and Rudolf Prager and Anton Luger and R. Pacher},
  journal={European Journal of Preventive Cardiology},
  year={2012},
  volume={19},
  pages={944 - 951}
}
Aims: Cardiovascular events are the most relevant events in patients with diabetes mellitus. We aimed to compare the predictive values of N-terminal pro-brain natriuretic peptide (NT-proBNP) and the state-of-the-art marker, albuminuria, for cardiac events in diabetic patients. Methods: In this prospective observational study we recruited 1071 patients with diabetes mellitus. NT-proBNP and albuminuria ⊟ defined as a urinary albumin/creatinine ratio >30 mg/g ⊟ were measured at baseline. Patients… 
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19 Citations
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Results Citations
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19 Citations

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PONTIAC (NT-proBNP selected prevention of cardiac events in a population of diabetic patients without a history of cardiac disease): a prospective randomized controlled trial.
Additive prognostic value of plasma N-terminal pro-brain natriuretic peptide and coronary artery calcification for cardiovascular events and mortality in asymptomatic patients with type 2 diabetes
TLDR
In patients with type 2 diabetes and microalbuminuria but without known coronary artery disease, NT-proBNP and CAC were strongly associated with fatal and nonfatal CVD, as well as with mortality.
N-Terminal Probrain Natriuretic Peptide Is a Stronger Predictor of Cardiovascular Mortality Than C-Reactive Protein and Albumin Excretion Rate in Elderly Patients With Type 2 Diabetes
TLDR
NT-proBNP is a strong independent predictor of short-term CV mortality risk in elderly people with type 2 diabetes, including those without preexisting CVD, and is additive to that provided by AER.
Prognostic value of NT-proBNP in patients with chronic coronary syndrome and normal left ventricular systolic function according to glucose status: a prospective cohort study
TLDR
It is indicated that NT-proBNP could well predict worse outcomes in dysglycemic patients with CCS and normal LVSF, suggesting thatNT- ProBNP may help with risk stratification in this population.
N-terminal pro-brain natriuretic peptide and risk of cardiovascular events in older patients with type 2 diabetes: the Edinburgh Type 2 Diabetes Study
TLDR
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.
Targeted multiple biomarker approach in predicting cardiovascular events in patients with diabetes
TLDR
GDF-15 and hs-TnT are strong independent cardiovascular biomarkers augmenting the predictive value of NT-proBNP in patients with diabetes, and showed a strong complementarity to predict future long-term risk.
Cardiovascular Outcomes According to Urinary Albumin and Kidney Disease in Patients With Type 2 Diabetes at High Cardiovascular Risk: Observations From the SAVOR-TIMI 53 Trial
TLDR
In patients with type 2 diabetes, UACR was independently associated with increased risk for a spectrum of adverse cardiovascular outcomes, however, the incremental cardiovascular prognostic value of UacR was minimal when evaluated together with contemporary cardiac biomarkers.
Prognostic Significance of Preprocedural N-Terminal Pro-B-Type Natriuretic Peptide Assessment in Diabetic Patients With Multivessel Coronary Disease Undergoing Revascularization
TLDR
NT-proBNP levels were an independent prognostic marker for adverse outcomes in diabetic patients with MVD undergoing coronary revascularization, suggesting that preprocedural NT- ProBNP measurement might help in the risk stratification of high-risk patients.
Comment on Hillis et al. The Relative and Combined Ability of High-Sensitivity Cardiac Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide to Predict Cardiovascular Events and Death in Patients With Type 2 Diabetes. Diabetes Care 2014;37:295–303
TLDR
This is now the third well-adjusted cohort showing the ability of NT-proBNP as a risk marker for cardiovascular disease in this setting and it is agreed that the clinical relevance still has to be proven in future trials.
Cardiovascular safety of metformin and sulfonylureas in patients with different cardiac risk profiles
TLDR
Metformin is associated with beneficial cardiovascular outcomes in patients with diabetes only when (sub)clinical cardiovascular risk defined by NT-proBNP levels is present.
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TLDR
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