NT-pro-BNP is associated with inducible myocardial ischemia in mildly symptomatic type 2 diabetic patients.
Baseline levels of N-terminal fragment of the brain natriuretic peptide prohormone (NT-pro-BNP) are associated with myocardial ischemia in non-diabetic patients with stable angina pectoris. A total of 281 patients with diabetes mellitus type 2 and stable angina pectoris underwent myocardial perfusion scintigraphy (MPS). Myocardial ischemia on MPS was present in 140 (50%) patients. These ischemic patients had significantly higher NT-pro-BNP levels compared with patients without ischemia: 183 pg/ml (64-324 pg/ml) vs. 88 pg/ml (34-207 pg/ml), respectively (p<0.001). In addition, NT-pro-BNP ≥180 pg/ml was an independent predictor of the presence of myocardial ischemia (OR 2.36, 95%CI 1.40-3.97, p=0.001). Possible confounding factors such as age and creatinine clearance were of no influence on the predictive value in this specific patient population. These findings strengthen the idea that NT-pro-BNP may be of value in the early detection of diabetic patients with hemodynamic significant coronary artery disease.
Wiersma
Jacobijne J
JJ
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: j.j.wiersma@amc.uva.nl.
van der Zee
P Marc
PM
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
van Straalen
Jan P
JP
Department of Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands.
Fischer
Johan C
JC
Department of Clinical Chemistry, Academic Medical Center, Amsterdam, The Netherlands.
van Eck-Smit
Berthe L F
BLF
Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Tijssen
Jan G P
JGP
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Trip
Mieke D
MD
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Piek
Jan J
JJ
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Verberne
Hein J
HJ
Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands.
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*
D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain