MR-proANP and incident cardiovascular disease in patients with type 2 diabetes with and without heart failure with preserved ejection fraction

Cardiovascular Diabetology

Magnus T. Jensen¹  Peter G. Jørgensen²  Jesper Jensen³  Morten Schou³  Jens Faber⁴  Caroline Kistorp⁵  Tine W. Hansen⁶  Henrik U. Andersen⁶  Peter Rossing⁷  Tina Vilsbøll⁷ 

[1] Department of Cardiology, Copenhagen University Hospital Amager-Hvidovre Hospital, Kettegård Alle 30, 2650, Hvidovre, Denmark;Department of Cardiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark;Department of Cardiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark;Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark;Department of Endocrinology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark;Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark;Department of Endocrinology, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark;Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark;Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark;Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark;Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark;

关键词: Cardiovascular disease;    Diabetes complications;    Macrovascular disease;    Type 2 diabetes;    MR-proANP;    Heart failure;   

DOI  :  10.1186/s12933-020-01155-9

来源: Springer

【 摘 要 】

BackgroundMid-regional pro-atrial natriuretic peptide (MR-proANP) is a useful biomarker in outpatients with type 2 diabetes (T2D) to diagnose heart failure (HF). Elevated B-type natriuretic peptides are included in the definition of HF with preserved ejection fraction (HFpEF) but little is known about the prognostic value of including A-type natriuretic peptides (MR-proANP) in the evaluation of patients with T2D.MethodsWe prospectively evaluated the risk of incident cardiovascular (CV) events in outpatients with T2D (n = 806, mean ± standard deviation age 64 ± 10 years, 65% male, median [interquartile range] duration of diabetes 12 [6–17] years, 17.5% with symptomatic HFpEF) according to MR-proANP levels and stratified according to HF-status including further stratification according to a prespecified cut-off level of MR-proANP.ResultsA total of 126 CV events occurred (median follow-up 4.8 [4.1–5.3] years). An elevated MR-proANP, with a cut-off of 60 pmol/l or as a continuous variable, was associated with incident CV events (p < 0.001). Compared to patients without HF, patients with HFpEF and high MR-proANP (≥ 60 pmol/l; median 124 [89–202] pmol/l) and patients with HF and reduced ejection fraction (HFrEF) had a higher risk of CV events (multivariable model; hazard ratio (HR) 2.56 [95% CI 1.64–4.00] and 3.32 [1.64–6.74], respectively). Conversely, patients with HFpEF and low MR-proANP (< 60 pmol/l; median 46 [32–56] pmol/l) did not have an increased risk (HR 2.18 [0.78–6.14]).ConclusionsPatients with T2D and HFpEF with high MR-proANP levels had an increased risk for CV events compared to patients with HFpEF without elevated MR-proANP and compared to patients without HF, supporting the use of MR-proANP in the definition of HFpEF from a prognostic point-of-view.

【 授权许可】

CC BY