Diabetes mellitus status modifies the association between N-terminal B-type natriuretic peptide and all-cause mortality risk in ischemic heart failure: a prospective cohort study

• Published in: Diabetology and metabolic syndrome Vol. 15; no. 1; p. 72
• Main Authors: Qiu, Weida, Cai, Anping, Xiao, Xiaoju, Gao, Zhiping, Feng, Yingqing, Li, Liwen
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.04.2023; BioMed Central; BMC
• Subjects: All-cause mortality; Brain natriuretic peptide; Cardiovascular disease; Cohort analysis; Congestive heart failure; Diabetes; Diabetes mellitus; Ejection fraction; Health aspects; Heart failure; Hemoglobin; Hypertension; Ischemia; Ischemic heart failure; Medical imaging; Medical laboratories; Medical research; Medicine, Experimental; Mortality; Natriuretic peptides; NT-proBNP; Peptides; Risk factors; Variables; Vital signs; Ischemic heart failure; All-cause mortality; NT-proBNP; Diabetes mellitus
• ISSN: 1758-5996; 1758-5996
• DOI: 10.1186/s13098-023-01046-5

N-terminal B-type natriuretic peptide (NT-proBNP) discriminates mortality risk in diabetes mellitus (DM) and in heart failure (HF) populations. Whether DM status modifies the association between NT-proBNP and all-cause mortality risk in ischemic HF is unknown. This was a single-center, prospective cohort study conducted with 2287 ischemic HF patients. Subjects were divided into with DM group and without DM group. Multivariate Cox proportional-hazards models were conducted to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). The product of DM status and NT-proBNP were used to assess the interaction. Propensity score matching analysis was used to verify the robustness of the results. Of 2287 ischemic HF participants, 1172 (51.2%) had DM. After a median follow-up of 3.19 years (7287 person-years), 479 (20.9%) of the participants died. After adjusting for the covariates, continuous NT-proBNP was more prominently associated with risk of mortality in HF patients with DM (HR: 1.65, 95% CI: 1.43-1.91) than those without (HR: 1.28, 95% CI: 1.09-1.50). A significant interaction of DM status and NT-proBNP was observed (P-interaction = 0.016). The relationships were consistent when NT-proBNP was considered as a categorical variable and in the propensity matching analysis. DM status modified the association between NT-proBNP and all-cause mortality in ischemic HF patients, suggesting that NT-proBNP was more prominently associated with risk of mortality in patients with DM than those without. Future studies to clarify the mechanisms underlying these observations are needed.