NT-pro BNP versus routine clinical risk factors as a predictor of cardiovascular events or death in people with dysglycemia – A brief report from the ORIGIN trial

For patients having diabetes with co-occurring cardiovascular and renal complications, circulating NT-pro BNP levels have a similar comparative capacity as multivariate models to forecast cardiac events or death. This finding was approved for patients with dysglycemia not selected for co-existing cardiorenal conditions. The research titled “NT-pro BNP versus routine clinical risk factors as a predictor of cardiovascular events or death in people with dysglycemia – A brief report from the ORIGIN trial” was conducted by Magnus. O. Wijkman and colleagues and the summary have been given below.

Objectives:

To test the hypothesis of whether NT-pro BNP distinguishes as well as externally confirmed risk models in broader populations of people with dysglycemia.

Method:

A randomized trial in a 2×2 factorial design was adopted to assess the cardiovascular potency and safety of insulin glargine compared with standard care and omega-3 fatty acids with placebo in 12537 participants with dysglycemia and cardiovascular risk events. 236 serum biomarkers and NT-proBNP were measured. Harrell’s C-statistics were employed to distinguish the discriminatory ability of NT-pro BNP as a univariate predictor with that of the multivariate model. SAS was employed for the statistical analysis.

Findings:

In ORIGIN participants, NT-pro BNP had identical discriminatory capacity as a multivariate risk model for any cardiac events or death. The result marks great significance since recent guidelines for medical care of diabetes or pre-diabetes patients recommend the use of risk scores but not natriuretic peptides.
Even though NT-pro BNP serves as an important predictor, it solely should not be a parameter to rely on or act in replacement of the conventional parameters.

Limitations:

NT-pro BNP was analyzed in the form of a nominal variable. This categorization is probably going to have belittled the strength of its association with the results, a conservative estimate of its discriminatory ability. The c-statistic of the NT-pro BNP was lower in ORIGIN than in previously reported groups of patients with diabetes, probably due to different distributions of the NT-proBNP values and different burdens of comorbidities and glycemia.

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