Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada.
Global Medical Diabetes, Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany.
Diabetes Care. 2022 Sep 1;45(9):2152-2155. doi: 10.2337/dc22-0453.
To use protein biomarkers to identify people with type 2 diabetes at high risk of cardiovascular outcomes and death.
Biobanked serum from 4,957 ELIXA (Evaluation of Lixisenatide in Acute Coronary Syndrome) trial participants was analyzed. Forward-selection Cox models identified independent protein risk factors for major adverse cardiovascular events (MACE) and death that were compared with a previously validated biomarker panel.
NT-proBNP and osteoprotegerin predicted both outcomes. In addition, trefoil factor 3 predicted MACE, and angiopoietin-2 predicted death (C = 0.70 and 0.79, respectively, compared with 0.63 and 0.66 for clinical variables alone). These proteins had all previously been identified and validated. Notably, C statistics for just NT-proBNP plus clinical risk factors were 0.69 and 0.78 for MACE and death, respectively.
NT-proBNP and other proteins independently predict cardiovascular outcomes in people with type 2 diabetes following acute coronary syndrome. Adding other biomarkers only marginally increased NT-proBNP's prognostic value.
利用蛋白质生物标志物识别 2 型糖尿病患者发生心血管不良结局和死亡的高危人群。
分析来自 4957 名 ELIXA（依泽替米贝用于急性冠脉综合征的评估）试验参与者的生物银行血清。正向选择 Cox 模型确定了与先前验证的生物标志物组合相比，可独立预测主要不良心血管事件（MACE）和死亡的蛋白质风险因素。
NT-proBNP 和骨保护素可预测两种结局。此外，三叶因子 3 预测 MACE，血管生成素-2 预测死亡（C 值分别为 0.70 和 0.79，而单独使用临床变量的 C 值分别为 0.63 和 0.66）。这些蛋白之前均已被识别和验证。值得注意的是，对于 MACE 和死亡，仅 NT-proBNP 加临床危险因素的 C 统计值分别为 0.69 和 0.78。
在急性冠脉综合征后，2 型糖尿病患者的 NT-proBNP 和其他蛋白质可独立预测心血管结局。添加其他生物标志物仅略微增加了 NT-proBNP 的预后价值。
