Observational studyDiabetes care2016
Natriuretic Peptide and High-Sensitivity Troponin for Cardiovascular Risk Prediction in Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study.
Observational study in Diabetes care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Pooled it
- Serum/plasma biomarkers and the progression of cardiometabolic multimorbidity: a systematic review and meta-analysis.Frontiers in public health · 2023Pooled it
- I Brazilian guideline on hypertension in dialysis of the Brazilian Society of Nephrology.Jornal brasileiro de nefrologiaGuideline
- Associations of Hypertension and Orthostatic Hypotension With Subclinical Cardiovascular Disease.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Trial
- NT-proBNP by Itself Predicts Death and Cardiovascular Events in High-Risk Patients With Type 2 Diabetes Mellitus.Journal of the American Heart Association · 2020Trial
- Cardiovascular Outcomes According to Urinary Albumin and Kidney Disease in Patients With Type 2 Diabetes at High Cardiovascular Risk: Observations From the SAVOR-TIMI 53 Trial.JAMA cardiology · 2018Trial
- Periodontitis, subclinical myocardial injury, and cardiovascular mortality among US adults: a population-based study.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025Article
- Diabetes, Subclinical Myocardial Injury or Stress, and Risk of Heart Failure Subtypes: The Jackson Heart Study.Diabetes care · 2025Observational
- A holistic approach to managing cardio-kidney metabolic syndrome: insights and recommendations from the Italian perspective.Frontiers in cardiovascular medicine · 2025Article
- Saudi Heart Association Position Statement on NT-proBNP for Cardiovascular Risk Screening in Asymptomatic Adults With Type 2 Diabetes Mellitus.Journal of the Saudi Heart Association · 2025Article
- Machine-learning-based prediction of cardiovascular events for hyperlipidemia population with lipid variability and remnant cholesterol as biomarkers.Health information science and systems · 2024Article
- Natriuretic Peptides and Heart Stress: Time to Screen the Asymptomatic High-Risk Population to Prevent Incident Heart Failure?Arquivos brasileiros de cardiologia · 2024Article
- Review
- Article
- Use of the energy waveform electrocardiogram to detect subclinical left ventricular dysfunction in patients with type 2 diabetes mellitus.Cardiovascular diabetology · 2024Article
- Universal Risk Prediction for Individuals With and Without Atherosclerotic Cardiovascular Disease.Journal of the American College of Cardiology · 2024Article
- Cardiovascular Disease and Alzheimer's Disease: The Heart-Brain Axis.Journal of the American Heart Association · 2023Review
- NT-proBNP and cardiovascular event risk in individuals with prediabetes undergoing cardiovascular evaluation.Diabetes research and clinical practice · 2023Article
- Associations of Cardiac Biomarkers With Peripheral Artery Disease and Peripheral Neuropathy in US Adults Without Prevalent Cardiovascular Disease.Arteriosclerosis, thrombosis, and vascular biology · 2023Article
- Subclinical Cardiovascular Disease in US Adults With and Without Diabetes.Journal of the American Heart Association · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 9 institutions in 2 countries.
Funding
Abstract
objectiveCardiovascular disease (CVD) is the major cause of morbidity and mortality in diabetes; yet, heterogeneity in CVD risk has been suggested in diabetes, providing a compelling rationale for improving diabetes risk stratification. We hypothesized that N-terminal prohormone brain natriuretic peptide (NTproBNP) and high-sensitivity troponin T may enhance CVD risk stratification beyond commonly used markers of risk and that CVD risk is heterogeneous in diabetes. RESEARCH DESIGN AND
methodsAmong 8,402 participants without prevalent CVD at visit 4 (1996-1998) of the Atherosclerosis Risk in Communities (ARIC) study there were 1,510 subjects with diabetes (mean age 63 years, 52% women, 31% African American, and 60% hypertensive).
resultsOver a median follow-up of 13.1 years, there were 540 incident fatal/nonfatal CVD events (coronary heart disease, heart failure, and stroke). Both troponin T ≥14 ng/L (hazard ratio [HR] 1.96 [95% CI 1.57-2.46]) and NTproBNP >125 pg/mL (1.61 [1.29-1.99]) were independent predictors of incident CVD events at multivariable Cox proportional hazard models. Addition of circulating cardiac biomarkers to traditional risk factors, abnormal electrocardiogram (ECG), and conventional markers of diabetes complications including retinopathy, nephropathy, and peripheral arterial disease significantly improved CVD risk prediction (net reclassification index 0.16 [95% CI 0.07-0.22]). Compared with individuals without diabetes, subjects with diabetes had 1.6-fold higher adjusted risk of incident CVD. However, participants with diabetes with normal cardiac biomarkers and no conventional complications/abnormal ECG (n = 725 [48%]) were at low risk (HR 1.12 [95% CI 0.95-1.31]), while those with abnormal cardiac biomarkers, alone (n = 186 [12%]) or in combination with conventional complications/abnormal ECG (n = 243 [16%]), were at greater risk (1.99 [1.59-2.50] and 2.80 [2.34-3.35], respectively).
conclusionsAbnormal levels of NTproBNP and troponin T may help to distinguish individuals with high diabetes risk from those with low diabetes risk, providing incremental risk prediction beyond commonly used markers of risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.