THE ROLE OF ELEVATED NT-PROBNP AND ALBUMINURIA AS CARDIO-VASCULAR RISK FACTORS IN TYPE 2 DIABETES MELLITUS PATIENTS AFTER ACUTE CORONARY SYNDROME
Background and Aims. The identification of type 2 diabetes mellitus (T2DM) patients with high cardio-vascular risk became more crucial, especially in patients with known coronary artery disease (CAD). Our study is focusing on T2DM patients who suffered recently an acute coronary syndrome (ACS), and evaluates the importance of albuminuria and NT-proBNP level as risk factors for short-term recurrence. Material and methods. 221 T2DM patients with recent ACS were evaluated 1 month after discharge, assessing NT-proBNP and albuminuria level and followed for 12 months for major adverse cardiac events (MACE). Results. Patients who reached the endpoint (33%) presented significantly higher levels of NT-proBNP (458.5 vs. 207.4 pg/ml, p<0.0001) and urinary albumin/creatinine ratio (80 vs. 27 mg/g, p<0.0001) than those who did not present a MACE in the follow-up period. Comparison of the MACE-free survival curves revealed that NT-proBNP has a better power than albuminuria in the prediction of the short-term outcome: hazard ratio (HR)=1.6176 (95%CI: 1.0047-2.6044), p=0.0433 vs. HR=1.4813 (95%CI: 0.8497-2.5824), p=0.1921. Only the NT-proBNP level entered the multivariable regression model besides age and represents an independent risk factor (HR=1.0025, 95%CI: 1.0014-1.0035, p=0.0036). Conclusion. NT-proBNP provides excellent prognostic information in patients with diabetes mellitus who recently suffered an ACS. Albuminuria wasn’t an independent risk factor in this cohort.