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

Lab Med. 2023 Jul 5;54(4):339-351. doi: 10.1093/labmed/lmac119.

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.

Keywords: cardiovascular disease; diabetes; mortality; natriuretic peptides; prediction; prognosis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biomarkers
  • Cardiovascular Diseases*
  • Diabetes Mellitus, Type 2* / complications
  • Humans
  • Natriuretic Peptide, Brain
  • Peptide Fragments
  • Prognosis
  • Risk Assessment

Substances

  • Natriuretic Peptide, Brain
  • Biomarkers
  • Peptide Fragments