Pro-B-type natriuretic peptide (proBNP) is a prognostic biomarker in various patient populations. Its power to predict cardiovascular events in the extremely high risk group of patients with the combination of established cardiovascular disease (CVD) and type 2 diabetes (T2DM) is unclear and is addressed in the present study. We measured serum proBNP in 900 patients with established CVD including 591 patients with angiographically verified coronary artery disease and 309 patients with sonographically proven peripheral artery disease. Prospectively, we recorded vascular events over 6.3±2.0 years. At baseline, proBNP was significantly higher in patients with (n=317) than in those without T2DM (990±2556 vs. 742±2328 pg/ml; p=0.003). The cardiovascular event rate was significantly higher among CVD patients with than among those without T2DM (50.5 vs. 35.1%; p<0.001). ProBNP significantly predicted the incidence of cardiovascular events after adjustment for age, gender, BMI, smoking, systolic and diastolic blood pressure, LDL cholesterol, HDL cholesterol and the eGFR both in patients with T2DM (standardized adjusted HR 1.48 [1.28-1.73]; p<0.001) and in subjects without T2DM (HR 1.33 [1.20-1.47]; p<0.001). We conclude that serum proBNP in patients with established CVD predicts future cardiovascular events independently of established cardiovascular risk factors both among those with as well as among those without T2DM.


C.H. Saely: None. A. Vonbank: None. C. Heinzle: None. D. Zanolin: None. B. Larcher: None. A. Mader: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.

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