N-Terminal Prohormone Brain Natriuretic Peptide as a Prognostic Biomarker for the Risk of Complications in Type 2 Diabetes: A Systematic Review and Meta-Analysis

Abstract

Objective This systematic review and meta-analysis aimed at summarizing the existing clinical evidence to evaluate the prognostic performance of N-terminal prohormone brain natriuretic peptide (NT-proBNP) in predicting cardiovascular events, cardiovascular-related mortality, and all-cause mortality in patients with type 2 diabetes. Methods Searches were performed in Medline, Embase, Scopus, and Web of Science databases before August 1, 2021. The data were recorded as adjusted hazard ratio (HR). Results An increase in NT-proBNP increases the risk of cardiovascular events (HR = 1.63), cardiovascular mortality (HR = 1.86) and all-cause mortality (HR = 1.54). Seemingly, the best cutoffs for predicting cardiovascular events (HR = 2.30) and cardiovascular mortality (HR = 3.77) are levels greater than 100 pg/mL. The best cutoff of NT-proBNP in predicting all-cause mortality is levels greater than 225 pg/mL (HR = 4.72). Conclusion A moderate level of evidence demonstrated that NT-proBNP serum levels can predict future cardiovascular events, cardiovascular mortality, and all-cause mortality. Thus, it can be used as risk stratification for type 2 diabetes.

Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review

“…A recently published meta-analysis by Ramzi et al [163] highlights that the presence of a serum N-terminal prohormone brain natriuretic peptide (NT-proBNP) level above 225 pg/mL correlates with a high risk of death from any cause among diabetic patients, while serum levels above 100 pg/mL are predictive of the occurrence of acute cardiovascular events. This biomarker, along with IL-6 and resistin, correlates with the presence of left ventricular dysfunction and left ventricular hypertrophy and can thus be used as noninvasive biomarkers for assessing cardiovascular risk in patients with DM [164].…”