Elevated pro-B type natriuretic peptide (pro-BNP) has been found to be a strong marker of cardiovascular risk in several high-risk populations. However, the power of pro-B type natriuretic peptide (pro-BNP) to predict major cardiovascular events (MACE) and mortality in patients with the combination of established cardiovascular disease and type 2 diabetes (T2DM) is unclear and is addressed in the present study. We enrolled 873 patients with established cardiovascular disease, 579 with angiographically proven stable CAD and 294 with sonographically proven peripheral artery disease. Prospectively, cardiovascular events were recorded over a mean follow-up period of 7.9±3.6 years. At baseline, pro-BNP was significantly higher in patients with T2DM (n=285) than in those who did not have diabetes (1010±26vs. 727±2327 mg/dl; p=0.003) . During follow-up, 257 patients suffered MACE; the event rate was significantly higher in patients with T2DM than in subjects without T2DM (37.8 vs. 26.0%; p<0.001) . pro-BNP predicted both MACE and mortality in the total study population, with standardized adjusted hazard ratios (HR) of 1.37 [1.26-1.48]; p<0.0 and 1.30 [1.21-1.40]; p<0.001, respectively. Further, pro-BNP predicted MACE and mortality in patients with T2DM (HRs 1.37 [1.21-1.55]; p<0.0 and 1.24 [1.10-1.40]; p<0.001, respectively) as well as in those who did not have diabetes (HRs 1.45 [1.26-1.67]; p<0.0 and 1.41 [1.25-1.60]; p<0.001, respectively) . Interaction terms pro-BNP x T2DM were non-significant for both MACE and mortality (p=0.590 and 0.3respectively) , indicating that the power of pro-BNP to predict MACE and mortality did not differ significantly between cardiovascular disease patients with T2DM and those who did not have diabetes. We conclude that pro-BNP strongly predicts MACE and mortality in cardiovascular disease patients with T2DM as well as in those without diabetes.
M.Maechler: None. L.Sprenger: None. A.Mader: None. B.Larcher: None. A.Vonbank: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None. C.H.Saely: None.