Kumar G, Lal MK, Singh G, Naik D. Correlation of Serum Nt-Pro Bnp Levels and Myocardial Performance Index in Asymptomatic Type 2 Diabetics for Assessment of Myocardial Ischaemia.
J Assoc Physicians India 2022;
70:11-12. [PMID:
35443399]
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Abstract
UNLABELLED
Diabetes mellitus is a global health problem. Cardiovascular events accounts for approximately 50 percent of mortality amongst the diabetics. Diabetics often present with silent myocardial ischaemia, since myocardial ischaemia is a strong trigger of N-terminal pro-B-type natriuretic peptide (NT-proBNP) release, we hypothesized that NT-proBNP might be useful in the early diagnosis. This study also evaluates whether any correlation exits between NT-proBNP levels and myocardial performance index (MPI).
MATERIAL
This case control study was done on 30 patients with type 2 diabetes and similar matched group of 30 controls. Investigations like fasting and postprandial sugar level, kidney function test, HBA1c, lipid profile and NT-ProBNP levels were done. TMT was done to diagnose silent MI. Echocardiography was performed to assess MPI. The outcome measures were cut off levels of NT-ProBNP for predicting silent myocardial ischaemia based on TMT. P<0.05 was considered as significant.
OBSERVATION
NT-proBNP (pg/mL) was significantly increased in Diabetics in comparison to controls (595.33±464.48 vs 110.97 ± 34.81, p <.0001). MPI was significantly higher in diabetics (0.54±0.08 vs 0.33±0.02, p<.0001), and NT-proBNP showed significant positive correlation myocardial performance index (r= 0.726, p<0.0001). Silent MI was seen in 18(60%) patients which was based on TMT testing. Compared to those without silent MI, patients with silent MI had higher NTproBNP levels (795.5 vs 106, p value=0.0001) and higher MPI (0.59 ± 0.06 vs 0.46 ± 0.05, p value<.0001). A cut off of NT-pro BNP(pg/ mL) of >152 predicted silent MI in 93.33% cases with 100% sensitivity, 83.33% specificity, 90% PPV and 100% NPV.
CONCLUSION
NT-proBNP is a novel marker with positive correlation with MPI. It may be used as an independent predictor for silent MI in diabetics, thereby helping in reduction and treatment of CVD among them. Thus, it is suggested to screen all asymptomatic diabetics for underlying myocardial ischaemia by MPI, preferably, or by NTproBNP levels.
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