Serial Measurement of Natriuretic Peptides and Cardiovascular Outcomes in Patients With Type 2 Diabetes in the EXAMINE Trial

Diabetes Care
Petr JarolimDavid A Morrow

Abstract

Patients with type 2 diabetes are at increased risk of developing heart failure (HF). Enhanced recognition of patients at risk for HF would help guide therapeutic decisions. We investigated the prognostic implications of changes in N-terminal B-type natriuretic peptide (NT-proBNP) concentration in patients with type 2 diabetes and ischemic heart disease who were enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial, a phase 3b trial of alogliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor. Patients with type 2 diabetes and a recent acute coronary syndrome event were eligible. NT-proBNP was measured at baseline and 6 months. Cardiovascular (CV) death or hospitalization for HF was the end point of principal interest for this analysis. We observed a strong graded relationship between increasing baseline and 6-month NT-proBNP concentration and the incidence of major CV events (P < 0.001). After adjusting for potential confounders, NT-proBNP at baseline was independently associated with the development of major CV events, in particular hospitalization for HF. Patients who had persistently high NT-proBNP (P < 0.001) or developed high NT-proBNP at 6 months (P < 0.001) were at a...Continue Reading

References

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Sep 18, 2015·The New England Journal of Medicine·Bernard ZinmanUNKNOWN EMPA-REG OUTCOME Investigators
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Dec 3, 2016·Journal of the American College of Cardiology·Michael R ZileScott D Solomon

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Citations

Apr 4, 2020·Diabetes, Obesity & Metabolism·Javed ButlerJulio Rosenstock
Feb 23, 2020·Clinical and Experimental Pharmacology & Physiology·Martin CaprndaVladimir Krasnik
Oct 2, 2019·Diabetology & Metabolic Syndrome·Alaaeldin BashierRobert Chilton
May 8, 2020·Cardiovascular Diabetology·Bo LiangNing Gu

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