Serial Measurement of Natriuretic Peptides and Cardiovascular Outcomes in Patients With Type 2 Diabetes in the EXAMINE Trial
Abstract
Objective Patients with type 2 diabetes are at increased risk of developing heart failure (HF). Enhanced recognition of patients at risk for HF would help guide therapeutic decisions. Research design and methods We investigated the prognostic implications of changes in N-terminal B-type natriuretic peptide (NT-proBNP) concentration in patients with type 2 diabetes and ischemic heart disease who were enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial, a phase 3b trial of alogliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor. Patients with type 2 diabetes and a recent acute coronary syndrome event were eligible. NT-proBNP was measured at baseline and 6 months. Cardiovascular (CV) death or hospitalization for HF was the end point of principal interest for this analysis. Results We observed a strong graded relationship between increasing baseline and 6-month NT-proBNP concentration and the incidence of major CV events ( P P P P = 0.20). Conclusions Serial monitoring of NT-proBNP in patients with type 2 diabetes and ischemic heart disease may be useful for identifying patients at highest risk for HF.
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In people with type 2 diabetes, measurement of natriuretic peptides, including BNP or NT-proBNP, identifies people at risk for heart failure development, progression of symptoms, and heart failure-related mortality.
“In people with type 2 diabetes, measurement of natriuretic peptides, including B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP), identifies people at risk for heart failure development, progression of symptoms, and heart failure-related mortality (223-225).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [224]
In people with type 2 diabetes, measurement of natriuretic peptides, including BNP or NT-proBNP, identifies people at risk for heart failure development, progression of symptoms, and heart failure-related mortality.
“In people with type 2 diabetes, measurement of natriuretic peptides, including B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP), identifies people at risk for heart failure development, progression of symptoms, and heart failure–related mortality (212–214).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [213]
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- Authors
- Jarolim, P., White, W. B., Cannon, C. P., Gao, Q., & Morrow, D. A.
- Affiliations
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
- University of Connecticut (US)
- Brigham and Women's Hospital (US)
- Baim Institute for Clinical Research (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2018-05-30
- Volume
- 41
- Issue
- 7
- Pages
- 1510-1515
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2807559974
- Cited by
- 56
- References
- 25
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 7 · 2023: 11 · 2022: 13 · 2021: 5 · 2020: 6 · 2019: 4
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- NT-proBNP, type 2 diabetes, heart failure, ischemic heart disease, alogliptin, DPP-4 inhibitors, serial biomarker measurement, cardiovascular outcomes, cardiovascular mortality, acute coronary syndrome, EXAMINE trial
- MeSH terms
- Equivalence Trials as Topic, Aged, Blood Chemical Analysis, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Double-Blind Method, Female, Hospitalization, Humans, Male, Middle Aged, Peptide Fragments, Piperidines, Prognosis, Uracil, Biomarkers, Natriuretic Peptide, Brain, Acute Coronary Syndrome
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