Nt-proBNP and 5-years survival Nt-proBNP and 5-years survival in a large cohort of type 2 in a large cohort of type 2

diabetes: diabetes: the Casale Monferrato Study. the Casale Monferrato Study.

M. PerottoM. Perotto, F. Panero, A. Landi, S. Miglietta, F. Monasterolo, P. Cavallo Perin, G. Bruno

Department of Internal Medicine, University of Turin, Italy.

M. G. S. D. 28/04 - 01/05/2011

NT – pro NT – pro BNPBNP

Mortality to 5 years

sex Years of diabetes

hypertension

smoking

HbA1c

age

ApoBApoA1

eGFR

CVD

AER

The Casale Monferrato The Casale Monferrato StudyStudy

2381 patients

666 patients

Randomized extraction

Identified by: • Paper archive of the patients attending the diabetes service at the Santo Spirito Hospital in Casale Monferrato

• Centralized file of all patients who have obtained exemption from payment for drugs, syringes, and glucose-monitoring strips owning to a diagnosis of diabetes

Resident in Casale Monferrato

Diabetes mellitus type 2

All causes mortalityAll causes mortality

NT-proBNP N death rate/1000person/yr IC 95%

0 – 48 14 15.0 8.89 – 25.36

49 – 102 24 27.1 18.16 – 40.43

103 – 232 38 46.9 34.13 – 64.46

> 233 80 107.0 85.9 – 133.22

NT-proBNP N death rate/1000person/yr IC 95%

0 – 48 3 3.2 1.04 – 9.98

49 – 102 9 10.2 5.28 – 19.53

103 – 232 22 27.2 17.88 – 41.24

> 233 38 50.8 39.98 – 69.25

CV mortalityCV mortality

Cox Multivariate AnalysisCox Multivariate Analysismortality all causes CV mortality

HRs Model 1

HRsModel 2

HRs Model 1

HRsModel 2

NT-proBNP0 – 48 1.00 1.00 1.00 1.00

49 – 1021.41

(0.72 – 2.75)3.62

(0.94 – 13.9)2.50

(0.67 – 9.33)2.11

(0.18 – 24.87)

103 – 2322.14

(1.13 – 4.06)3.88

(1.01 – 14.86)5.92

(1.72 – 20.38)6.88

(0.74 – 63.64)

> 2334.42

(2.41 – 8.08)8.96

(2.35 – 34.17)10.03

(2.97 – 33.85)8.07

(0.88 – 73.48)

P for trend

<0.0001 0.011 <0.0001 <0.001

Diabetologia. 2006 Oct;49(10):2256-62. Epub 2006 Aug 26.Plasma N-terminal pro-B-type natriuretic peptide and mortality in type 2 diabetes.L. Tarnow, M.-A. Gall, B. V. Hansen,  P. Hovind and H.-H. Parving