Prognostic value of NH2-terminal pro B-type natriuretic peptide in patients with diabetes and stable coronary heart disease.

C ardiovascular disease is the most frequent cause of death in patients with diabetes (1). It is difficult to evaluate the cardiovascular status of patients with diabetes because of complex symptomology, evidence of silent ischemia, and subclinical cardiac disease. Brain (B-type) natriuretic peptide (BNP) and the NH2terminal fragment of its prohormone (NT-proBNP) are novel biomarkers, which are released from cardiomyocytes in response to myocyte stretch. BNP and NT-proBNP both predict morbidity and mortality in the general population and in high-risk groups (2,3). In patients with diabetes, BNP is a promising screening marker for left-ventricular dysfunction, and both BNP and NT-proBNP are markers of increased risk (4 – 6). It is not known whether NT-proBNP is a useful risk marker in patients with diabetes and established coronary heart disease.