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NT-pro-BNP measured at discharge predicts outcome in multimorbid diabetic inpatients with a broad spectrum of cardiovascular disease

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Abstract

The prognostic value of NT-pro-BNP has not been thoroughly evaluated in diabetic inpatients with manifest cardiovascular disease. NT-pro-BNP was measured in 156 patients with type 2 diabetes mellitus hospitalised due to cardiovascular disease. The association of NT-pro-BNP with mortality and the combined endpoint (CE) of death, heart failure decompensation, stroke and myocardial infarction was analysed during a median follow-up time of 1183 days. Patients who died (1669 IQR 788–5640 vs. 398, IQR 158–990 pg/ml) and patients with CE (1353, IQR 730-4289 vs. 304, IQR 128–784 pg/ml, both p=0.0001) had significantly elevated NT-pro-BNP compared to patients without the corresponding endpoint. Patients with supramedian NT-pro-BNP (>518 pg/ml) had significantly worse outcome regarding mortality (HR 5.5, 95%CI 2.0–14.8) and CE (HR 5.0, 95%CI 2.2–11.2) than patients with inframedian values even after adjustment for age, NYHA class and renal function. At a cut-off of 422 pg/ml, NT-pro-BNP showed a sensitivity of 89.6% and a negative predictive value of 92.8% for detection of patients with future CE. In this sample of diabetic patients with a broad spectrum of cardiovascular disease, NT-pro-BNP was a strong predictor of long-term outcome. NT-pro-BNP measured at discharge identifies high-risk patients independently of the underlying heart disease.

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Authors and Affiliations

  1. Department III of Internal Medicine, University of Cologne, Josef-Stelzmann Str. 9, D-50924, Cologne, Germany

    R. Pfister, D. Tan, J. Thekkanal, E. Erdmann & C. A. Schneider

  2. Institute of Medical Statistics Informatics and Epidemiology, University of Cologne, Cologne, Germany

    M. Hellmich

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  1. R. Pfister
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  2. D. Tan
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  3. J. Thekkanal
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  4. M. Hellmich
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  5. E. Erdmann
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  6. C. A. Schneider
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Correspondence to R. Pfister.

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Pfister, R., Tan, D., Thekkanal, J. et al. NT-pro-BNP measured at discharge predicts outcome in multimorbid diabetic inpatients with a broad spectrum of cardiovascular disease. Acta Diabetol 44, 91–97 (2007). https://doi.org/10.1007/s00592-007-0248-4

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  • DOI: https://doi.org/10.1007/s00592-007-0248-4

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