TY - JOUR
T1 - Impact of age on the predictive value of NT-proBNP in patients with diabetes mellitus stabilised after an acute coronary syndrome
AU - Savonitto, Stefano
AU - Morici, Nuccia
AU - Pancani, Silvia
AU - Nozza, Anna
AU - Cosentino, Francesco
AU - Perrone Filardi, Pasquale
AU - Cavallini, Claudio
AU - Angeli, Fabio
AU - Stähli, Barbara E.
AU - Heerspink, Hiddo J.L.
AU - Mannini, Andrea
AU - Schwartz, Gregory G.
AU - Lincoff, A. Michael
AU - Tardif, Jean Claude
AU - Grobbee, Diederick E.
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2024/2
Y1 - 2024/2
N2 - Aims: To assess the impact of age on the prognostic value of NT-proBNP concentration in patients with type-2 diabetes mellitus (T2DM) stabilised after an Acute Coronary Syndrome (ACS). Methods: The AleCardio study compared aleglitazar with placebo in 7226 patients with T2DM and recent ACS. Patients with heart failure were excluded. Median follow-up was 104 weeks. Baseline NT-proBNP plasma concentration was measured centrally. Multivariable Cox regression was used to determine the mortality predictive information provided by NT-proBNP across age groups. Results: Median age was 61y (IQR 54, 67). NT-proBNP concentration increased by quartile (Q) of age (median 264, 318, 391, and 588 pg/ml). Compared to Q1, patients in Q4 of NT-proBNP had higher (p < 0.001) adjusted HR for all-cause (aHR 6.9; 95 % CI 4.0–12) and cardiovascular (11; 5.4–23) death. Within each age Q, baseline NT-proBNP in patients who died was 3 times higher than in survivors (all p < 0.001). When age and NT-proBNP levels were modeled as continuous variables, their interaction term was nonsignificant. The relative prognostic information provided by NT-proBNP (percent of total X2) increased from 38 % in age Q1 to 75 % in age Q4 for mortality, and from 50 % to 88 % for CV death. Conclusions: Among patients with T2DM stabilised after an ACS, NT-proBNP level predicts death irrespective of age.
AB - Aims: To assess the impact of age on the prognostic value of NT-proBNP concentration in patients with type-2 diabetes mellitus (T2DM) stabilised after an Acute Coronary Syndrome (ACS). Methods: The AleCardio study compared aleglitazar with placebo in 7226 patients with T2DM and recent ACS. Patients with heart failure were excluded. Median follow-up was 104 weeks. Baseline NT-proBNP plasma concentration was measured centrally. Multivariable Cox regression was used to determine the mortality predictive information provided by NT-proBNP across age groups. Results: Median age was 61y (IQR 54, 67). NT-proBNP concentration increased by quartile (Q) of age (median 264, 318, 391, and 588 pg/ml). Compared to Q1, patients in Q4 of NT-proBNP had higher (p < 0.001) adjusted HR for all-cause (aHR 6.9; 95 % CI 4.0–12) and cardiovascular (11; 5.4–23) death. Within each age Q, baseline NT-proBNP in patients who died was 3 times higher than in survivors (all p < 0.001). When age and NT-proBNP levels were modeled as continuous variables, their interaction term was nonsignificant. The relative prognostic information provided by NT-proBNP (percent of total X2) increased from 38 % in age Q1 to 75 % in age Q4 for mortality, and from 50 % to 88 % for CV death. Conclusions: Among patients with T2DM stabilised after an ACS, NT-proBNP level predicts death irrespective of age.
KW - Acute coronary syndrome
KW - Aging
KW - Diabetes
KW - Mortality
KW - Natriuretic peptides
UR - https://www.scopus.com/pages/publications/85183520596
U2 - 10.1016/j.diabres.2024.111112
DO - 10.1016/j.diabres.2024.111112
M3 - Article
C2 - 38278494
AN - SCOPUS:85183520596
SN - 0168-8227
VL - 208
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 111112
ER -