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Diabetes and NT-proBNP: Partners in crime

Published:November 18, 2022DOI:https://doi.org/10.1016/j.diabres.2022.110165
      In the present issue, Wijkman et al provide compelling evidence that N-terminal prohormone type B natriuretic peptide (NT-proBNP) has prognostic value for predicting mortality in patients with type 2 diabetes (T2D)[
      • Wijkman M.O.
      • Claggett B.L.
      • Malachias M.V.B.
      • Vaduganathan M.
      • Ballantyne C.M.
      • Kitzman D.W.
      • et al.
      Importance of NT-proBNP and conventional risk factors for prediction of death in older adults with and without diabetes mellitus– a report from the Atherosclerosis Risk in Communities (ARIC) study.
      ]. In a community-based cohort of 5861 individuals, followed for median of 7.2 years, they showed that NT-proBNP alone could discriminate the risk of mortality better than conventional risk factors among individuals with T2D [
      • Wijkman M.O.
      • Claggett B.L.
      • Malachias M.V.B.
      • Vaduganathan M.
      • Ballantyne C.M.
      • Kitzman D.W.
      • et al.
      Importance of NT-proBNP and conventional risk factors for prediction of death in older adults with and without diabetes mellitus– a report from the Atherosclerosis Risk in Communities (ARIC) study.
      ]. Remarkably, the prognostic value of NT-proBNP was similar to that achieved with the Pooled Cohorts Equation, which includes all the following variables: age, sex, black race, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, use of antihypertensive medication, and smoking status, plus the estimated glomerular filtration rate, high sensitivity-C-reactive protein level, and high sensitivity-troponin T level. This evidence is nicely summarized in Figure 1 and highlights the extremely high prognostic value of NT-proBNP in patients with diabetes. In patients without T2D, the discriminatory ability of NT-proBNP was similar to that observed with the Pooled Cohorts Equation (1).
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