Prognostic and comparative performance of cardiovascular risk markers in patients with type 2 diabetes

• Published in: Journal of diabetes 2021-09, Vol.13 (9), p.754-763
• Main Authors: Busch, Nikolaj, Jensen, Magnus T., Goetze, Jens P., Schou, Morten, Biering‐Sørensen, Tor, Fritz‐Hansen, Thomas, Andersen, Henrik U., Vilsbøll, Tina, Rossing, Peter, Jørgensen, Peter G.
• Format: Article
• Language: English
• Subjects: 2型糖尿病; Aged; albuminuria; Albuminuria - urine; Biomarkers; Biomarkers - metabolism; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - complications; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - urine; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - metabolism; Diagnostic tests; echocardiography; Electrocardiography; Female; Health risks; Humans; Male; Medical prognosis; Middle Aged; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; plasma NT‐proBNP; Prognosis; Prospective Studies; Risk Factors; type 2 diabetes; Ultrasonic imaging; Ultrasonography; Urinalysis; 心电图; 蛋白尿; 血浆NT‐proBNP; 超声心动图
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.13172

Background Diagnostic tests including echocardiography, albuminuria, electrocardiogram (ECG), high‐sensitivity troponin I (hs‐TnI), and N‐terminal prohormone brain natriuretic peptide (NT‐proBNP) have been suggested as cardiovascular (CV) risk predictors in type 2 diabetes. We studied the separate and combined prognostic yield of these risk markers. Methods In all, 1030 patients with type 2 diabetes were recruited from specialized clinics in this prospective cohort study. Full echocardiographic evaluation was feasible in 886 patients in sinus rhythm with adequate image quality. ECG was performed in 998 patients. Albuminuria was measured in 1009 and NT‐proBNP/hs‐TnI in 933 patients. The end point was a composite of CV events. Results The median follow‐up was 4.7 years (interquartile range: 4.0‐5.3), and 174 patients experienced a CV disease event. All considered markers, except hs‐TnI, were significantly (P 150 pg/mL) 3.05 (2.11‐4.40), and hs‐TnI 1.12 (0.79‐1.59). After adjusting for clinical variables, all remained significantly associated with the end point. However, after adjusting for each other, only NT‐proBNP >150 pg/mL remained significantly associated with the end point (2.07 [1.28‐3.34], P 150pg/mL)3.05(2.11‐4.40)和hs‐TnI 1.12(0.79‐1.59) 均与预后显著相关(P150pg/mL与终点显著相关(2.07[1.28‐3.34], P