It is widely recognized that patients with diabetes mellitus have an increased risk for cardiac disease.Aim
To establish the value of NT-proBNP as an independent risk factor for cardiac disease in diabetes mellitus patients and to compare it with classical risk factors such as high LDL-colesterol (defined as > 100mg/dl, with or without treatment) and microalbuminuria (defined as 30-300mg/24h).Method
1000 diabetic patients with no previous evidence of cardiovascular disease were followed-up for 1 year. Patients were matched for age, sex, HbA1c and onset of diabetes. NT-proBNP, LDL-colesterol and microalbuminuria were measured at baseline. The endpoint was defined as a composite cardiac event (stable angina, silent cardiac ischemia, acute coronary syndrome, heart failure or cardiac death).Results
56 patients (5.6%) reached the endpoint during follow-up period. At baseline, amongst 56 patients who undergone a cardiac event 26.8% had microalbuminuria, 23.2% had high LDL-colesterol and 48.3% had high plasma NT-proBNP (cut-off value 120pg/ml). After ajusting variables, NT-proBNP proved a higher predictive value than LDL-colesterol (OR=4.639; 95%CI, 1.829-11.763; P=0.0018), and microalbuminuria, respectively (OR=3.484; 95%CI, 1.435-8.461; P=0.0093). In our study LDL-colesterol had the same predictive value as microalbuminemia (OR= 0.7511; 95%CI, 0.2627-2.148; P= 0.7896).Conclusion
Our study proved that NT-proBNP is a better independent risk factor for cardiac disease than microalbuminuria and LDL-colesterol in patients with diabetes mellitus.