Abstract 11495: The Association between Amino Terminal Pro-Brain Natriuretic Peptide and Incident Heart Failure in Diabetes- The Multi Ethnic Study of Atherosclerosis
Background Heart Failure has become a common manifestation of cardiovascular disease (CVD) among diabetics. There is limited data on the role of amino-terminal pro-BNP (NT-proBNP) as a predictor of incident heart failure (HF) in diabetics.
Objective To investigate the relationship between plasma levels of NT-proBNP and incident HF in diabetics in a large mult-ethnic cohort free of CVD.
Methods The Multi-Ethnic Study of Atherosclerosis (MESA) is a multicenter cohort study of 6,814 white, African American, Hispanic, and Chinese participants aged 45 to 84 years. NT-proBNP was assayed in 5597 participants. Cox proportional hazard (CPH) models were used to analyze the association of NT-proBNP with incident HF in diabetes and to formally test for an interaction between NT-proBNP and diabetes.
Results During a median follow-up of 6.4 years, 124 participants developed HF. The incidence rate was significantly higher in diabetics compared to non-diabetics (9.66 vs 2.72 per 1000 person-years). Similarly, the adjusted incidence rates by NT-proBNP quartiles demonstrated a signficantly higher incidence of HF in patients with diabetes and NT-proBNP values above the 75th percentile (Table 1). Participants with diabetes had higher NT-proBNP values (56.5 pg/ml [50.7- 62.9]) than those without diabetes (50.1 pg/ml [48.5-51.8]) (p=0.024). In CPH models, participants with diabetes had 2.32 times higher risk of incident HF when compared to non-diabetics (p<0.001). Further analyses demonstrated a positive interaction between NT-proBNP and diabetes (p<.007).
Conclusions NT-proBNP levels were significantly elevated in diabetics compared with non-diabetics. Participants with elevated NT-proBNP had significantly increased risk of incident HF in diabetics compared to non-diabetics. Our data suggest that screening diabetic patients for plasma NT-proBNP may identify those that need further evaluation by echocardiogram and intervention for left ventricular dysfunction.
- © 2011 by American Heart Association, Inc.