Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Winkler, K; Wanner, C; Drechsler, C; Lilienthal, J; März, W; Krane, V; German Diabetes and Dialysis Study Investigators.
Change in N-terminal-pro-B-type-natriuretic-peptide and the risk of sudden death, stroke, myocardial infarction, and all-cause mortality in diabetic dialysis patients.
Eur Heart J. 2008; 29(17):2092-2099
Doi: 10.1093/eurheartj/ehn278
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- Co-Autor*innen der Med Uni Graz
- März Winfried
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- Abstract:
- N-terminal-pro-B-type-natriuretic-peptide (NT-pro-BNP) concentrations are altered in renal failure. This study examined the effect of baseline and change from baseline NT-pro-BNP on cardiovascular outcome and mortality in haemodialysis patients. On the basis of the German Diabetes and Dialysis Study, which evaluated atorvastatin in 1255 type 2 diabetes mellitus (T2DM) haemodialysis patients (median follow-up 4 years), the impact of NT-pro-BNP on pre-specified, adjudicated endpoints was investigated: sudden death (SD; n = 160), stroke (n = 99), myocardial infarction (MI; n = 200), cardiovascular events (CVEs: cardiac death, MI, stroke; n = 465), all-cause mortality (n = 612). Patients with baseline NT-pro-BNP ≥ 9252 pg/mL (fourth quartile) exhibited a more than four-fold risk of stroke [hazard ratio (HR) 4.1; 95% confidence interval (CI) 2.0-8.4] and a more than two-fold risk of SD (HR 2.0; 95% CI 1.2-3.3), CVE (HR 2.0; 95% CI 1.5-2.7), and mortality (HR 2.1; 95% CI 1.6-2.7) compared with patients with baseline NT-pro-BNP ≤ 1433 pg/mL (first quartile). Change in NT-pro-BNP was strongly associated with SD, CVE, and mortality. Doubling of NT-pro-BNP increased the risk of death by 46% (95% CI 1.1-2.0). Neither baseline nor change in NT-pro-BNP was significantly associated with MI. Increasing NT-pro-BNP is a risk factor for SD, CVE, and mortality in haemodialysis patients with T2DM. Whether NT-pro-BNP-guided treatment improves outcome needs to be evaluated prospectively.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Aged, 80 and over -
- Biomarkers - metabolism
- Death, Sudden, Cardiac - epidemiology
- Diabetes Mellitus, Type 2 - mortality
- Diabetic Nephropathies - mortality
- Double-Blind Method -
- Female -
- Female - epidemiology
- Humans -
- Kaplan-Meier Estimate -
- Male -
- Myocardial Infarction - mortality
- Natriuretic Peptide, Brain - metabolism
- Peptide Fragments - metabolism
- Renal Dialysis - mortality
- Risk Factors -
- Stroke - mortality
- Treatment Outcome -
- Young Adult -
- Find related publications in this database (Keywords)
- NT-pro-BNP
- serial measurement
- cardiovascular events
- mortality
- haemodialysis
- diabetes mellitus