Natriuretic Peptides and Prognosis in Patients With Type 2 Diabetes Mellitus and High Risk for Cardiovascular Events.

Autor: Khan MS; Division of Cardiology, Duke University, Durham, North Carolina., Januzzi JL Jr; Massachusetts General Hospital and Baim Institute for Clinical Research, Boston, Massachusetts., Liu Y; Massachusetts General Hospital and Baim Institute for Clinical Research, Boston, Massachusetts., Xu J; Janssen Research & Development, LLC, Spring House, Pennsylvania., Shaw W; Janssen Research & Development, LLC, Raritan, New Jersey., Sattar N; Glasgow Cardiovascular Research, Glasgow, UK., Mahaffey KW; Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California., Neal B; The George Institute for Global Health, UNSW Sydney, Sydney, Australia; Charles Perkins Centre, University of Sydney, Sydney, Australia; Imperial College London, London, UK., Hansen MK; Janssen Research & Development, LLC, Spring House, Pennsylvania., Butler J; Baylor Scott and White Research Institute, Dallas, Texas; University of Mississippi, Jackson, Mississippi. Electronic address: Javed.Butler@bswhealth.org.
Jazyk: angličtina
Zdroj: Journal of cardiac failure [J Card Fail] 2024 Dec; Vol. 30 (12), pp. 1544-1551. Date of Electronic Publication: 2024 Apr 16.
DOI: 10.1016/j.cardfail.2024.03.010
Abstrakt: Background: The prognosis of individuals with and without an established heart failure (HF) diagnosis and similarly elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels is not well-known.
Methods and Results: CANVAS (Canagliflozin Cardiovascular Assessment Study) trial participants were stratified according to baseline NT-proBNP quartiles and history of HF at baseline. Adjusted event rates per 1000 patient-years of follow-up for hospitalizations for HF, cardiovascular mortality, and kidney events were assessed, and hazard ratios (HR) were calculated using Cox proportional hazard models. Of the 3507 participants with available NT-proBNP concentrations, 471 (13.4%) had history of HF. The incidence rate per 1000 patient-years for hospitalizations for HF increased across the NT-proBNP quartiles in patients with (0, 2.8, 13.4, and 40.1; P < .001) and without (1.8, 3.1, 6.0, and 19.1; P < .001) HF, with a significantly higher risk in patients with HF compared with those without (with HF, quartile 3 HR 9.28 [interquartile range (IQR) 1.15-75.05]; P = .04; without HF, quartile 4 HR 4.86 [95% CI, 2.08-11.35]; P < .001). A similar higher risk for kidney events was seen in HF patients (with HF, quartile 4 HR 6.94 [95% CI, 2.66-18.08]; P = .001; without HF, quartile 4 HR 4.85 [95% CI, 3.02-7.80]; P = .001). Similar trends were seen for cardiovascular mortality.
Conclusions: Among patients with type 2 diabetes and cardiovascular risk, an elevated NT-proBNP level was associated with worse HF and kidney outcomes in general, regardless of history of HF; however, the presence of a clinical diagnosis of HF at baseline was associated with an incrementally higher risk, particularly in higher NT-proBNP quartiles.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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