259 T2DM patients with microalbuminuria eUACR >30 irrespective of their A1c, on standard glucose lowering, lipid lowering and ARB (telmisartan TM or valsartan Vs as first line BP lowering therapy until optimal dose was achieved, were followed-up for 2 years. Renal (Cr, eGFR, UACR) and CV (BP, BMI, Lipid profile, hs-CRP) parameters were assessed every 6 months. NT-ProBNP was measured at the end of 2 years. Patients with history of major surgery, coronary intervention, IHD or hospitalization in last 1 year, eGFR <45, hyperkalemia >5.3 were excluded Data was analyzed using PSPP version 1.0.1 and represented as Mean (SD) and paired-t test was used, p-value of 0.05 was considered to be significant.
Results: 42.1% used TM and 57.9% used Vs. Average dose of TM 66.76mg (±52.63) and Vs 165.33 (±89.94) Baseline characteristics: 259 patients (females 45.6%, male 54.4%), mean age 61.22 years (±9.50); weight 78.91kg (±15.78), BMI 30.63 (5.81±), DOD 12.9 years (7.52±), SBP 137.09mm (±20.60), DBP 77.54 (±11.31). There was a significant mean reduction observed in HbA1c 1.21% (95% CI 1.02-1.39, p-<0.001), SBP 3.37mm (95% CI 0.66-6.08, p-0.015), TC 14.13mg% (95% CI 8.43-19.83, p <0.001), LDL 10.64mg% (95% CI 5.87-15.41, p <0.001), TG 19.52mg% (95% CI 11.50-27.55, p<0.001), non-HDL 25.31mg% (95% CI 18.95-31.66, p<0.001), Chol remnant 8.25mg% (95% CI 5.27-11.22, p <0.001), UACR 147.5mg% (95% CI 61.27-233.79, p 0.001). There was no significant change seen in weight, BMI, DBP, HDL, Cr, eGFR, potassium. The NT-ProBNP was 166.30 pg/ml (±242.72) remained elevated after 2 years.
Conclusion: Despite optimal use of ARB and reduction in renal (UACR, maintenance of renal function) and CV risk factors there remains a significant risk for future CV mortality as suggested by elevated NT-ProBNP in T2DM with microalbuminuria.
V. Gupta: None. V. Teli: None.
