The Midregional Fragment of Pro-A-Type Natriuretic Peptide, Blood Pressure, and Mortality in a Prospective Cohort Study of Patients With Type 2 Diabetes (ZODIAC-25)

Kornelis J. J. van Hateren*, Gijs W. D. Landman, Nanne Kleefstra, Klaas H. Groenier, Joachim Struck, Gerjan J. Navis, Stephan J. L. Bakker, Sebastiaan T. Houweling, Klaas van der Meer, Henk J. G. Bilo

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

12 Citaten (Scopus)


OBJECTIVE-Evidence that midregional fragment of pro-A type natriuretic peptide (MR-proANP) is a marker of mortality in patients with type 2 diabetes is limited. Therefore, we aimed to investigate the capabilities of MR-proANP in predicting mortality. We also investigated whether MR-proANP influences the relationship between blood pressure and mortality in old age.

RESEARCH DESIGN AND METHODS-In 1998, 1,143 primary care patients with type 2 diabetes participated in the ZODIAC study. Because blood was drawn for 867 patients (76%) and confounders were missing for 19 patients, the final study sample comprised 848 patients. After a follow-up time of 10 years, we used Cox proportional hazard models to evaluate the relationship between MR-proANP and (cardiovascular) mortality. Harrell C statistic was used to compare models with and without MR-proANP. The regression analyses were repeated without MR-proANP for patients aged older than 75 years.

RESULTS-Median MR-proANP in the total study sample was 75 pmol/L (interquartile range, 48-124 pmol/L). During follow-up, 354(42%) out of 848 patients had died, of whom 152(43%) deaths were attributable to cardiovascular factors. MR-proANP was independently associated with all-cause and cardiovascular mortality, irrespective of age. During old age, there was a significant inverse relationship between blood pressure and mortality. This relationship did not change after adjustment for MR-proANP.

CONCLUSIONS-MR-proANP is independently associated with mortality in patients with type 2 diabetes. MR-proANP did not influence the inverse relationship between blood pressure and mortality in elderly patients.

Originele taal-2English
Pagina's (van-tot)1347-1352
Aantal pagina's6
TijdschriftDiabetes Care
Nummer van het tijdschrift5
StatusPublished - mei-2013

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