April - June 2011, Volume 7, Issue 2

Babes E, Babes V, Popescu M, Ardelean A

Value of N-Terminal Pro-B-Type Natriuretic Peptide in Detecting Silent Ischemia and its Prognostic Role in Asymptomatic Patients with Type 2 Diabetes Mellitus

Acta Endo (Buc) 2011, 7 (2): 209-218
doi: 10.4183/aeb.2011.209

Context. Patients with diabetes mellitus have high-risk of coronary artery disease that is often silent. NT-proBNP is a\r\nneurohormone that in recent studies proved useful in detecting ischemic heart disease.\r\nThe objective was to evaluate whether NT-proBNP can detect silent myocardial ischemia and can predict cardiovascular outcome and mortality in asymptomatic patients with type 2 diabetes.\r\nMethods. This study was conducted on 250 patients with type 2 diabetes mellitus without known coronary heart disease and heart failure. All patients were evaluated at baseline and were followed-up prospectively for 3 years for major cardiac events. Exercise ECG and Holter ECG were performed for silent ischemia detection. NT-proBNP was determined on a ROCHE cardiac reader.\r\nResults. NT-pro BNP was significantly raised in patients with silent ischemia (p<0.0001) and remained independent and the strongest predictor of silent ischemia in multiple regression analysis (p<0.0001). NTproBNP levels in patients who experienced major cardiac events were significantly higher (p<0.0001). In multiple regression analysis only silent ischemia (p<0.0001, r=0.20) and NT-proBNP (p<0.0001, r=0.67) remained independent predictors for major cardiac events.\r\nConclusions. NT-proBNP can be useful in screening for silent ischemia in asymptomatic type 2 diabetic patients and also is a strong predictor for major cardiac events.

Keywords: diabetes , NT-proBNP , prognostic, silent ischemia

Correspondence: Emilia Babes MD, Faculty of Medicine and Pharmacy, Clinical County Emergency Hospital - Cardiology, Gh.Doja, 65 Oradea 410169, Romania Email:babes.emilia@gmail.com