Prevalence of heart failure and the diagnostic value of MR-proANP in outpatients with type 2 diabetes
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Prevalence of heart failure and the diagnostic value of MR-proANP in outpatients with type 2 diabetes. / Jensen, Jesper; Schou, Morten; Kistorp, Caroline; Faber, Jens; Hansen, Tine W.; Jensen, Magnus T.; Andersen, Henrik U.; Rossing, Peter; Vilsbøll, Tina; Jørgensen, Peter G.
I: Diabetes, Obesity and Metabolism, Bind 21, Nr. 3, 2019, s. 736-740.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Prevalence of heart failure and the diagnostic value of MR-proANP in outpatients with type 2 diabetes
AU - Jensen, Jesper
AU - Schou, Morten
AU - Kistorp, Caroline
AU - Faber, Jens
AU - Hansen, Tine W.
AU - Jensen, Magnus T.
AU - Andersen, Henrik U.
AU - Rossing, Peter
AU - Vilsbøll, Tina
AU - Jørgensen, Peter G.
PY - 2019
Y1 - 2019
N2 - The prevalence of heart failure (HF) in patients with type 2 diabetes (T2DM) is debatable and no data exist concerning the diagnostic value of mid-regional pro-atrial natriuretic peptide (MR-proANP). We aimed to identify HF prevalence and evaluate the diagnostic value of MR-proANP in outpatients followed in two specialized diabetes clinics. HF was pre-defined as HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). The prevalence of HFrEF and HFpEF was 2.4% and 17.5%, respectively. An MR-proANP <60 pmol/L ruled out HFrEF in the total population (n = 806) and in patients reporting dyspnea (n = 311) with a sensitivity of 94.7% and 87.5%, a negative predictive value of 99.7% and 99.0%, a specificity of 39.5% and 33.0%, and a positive predictive value of 3.6% and 3.3%, respectively. In a multivariable model including age, sex, T2DM duration, albuminuria, uncontrolled systolic blood pressure, abnormal electrocardiogram and ischaemic heart disease for diagnosis of HF in patients reporting dyspnea, adding MR-proANP increased the area under the curve from 0.69 to 0.78 (P < 0.001). In conclusion, HFrEF was rare among outpatients with T2DM. MR-proANP rules out HFrEF and contributes independent information relevant to diagnosis of HF in patients reporting dyspnea.
AB - The prevalence of heart failure (HF) in patients with type 2 diabetes (T2DM) is debatable and no data exist concerning the diagnostic value of mid-regional pro-atrial natriuretic peptide (MR-proANP). We aimed to identify HF prevalence and evaluate the diagnostic value of MR-proANP in outpatients followed in two specialized diabetes clinics. HF was pre-defined as HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). The prevalence of HFrEF and HFpEF was 2.4% and 17.5%, respectively. An MR-proANP <60 pmol/L ruled out HFrEF in the total population (n = 806) and in patients reporting dyspnea (n = 311) with a sensitivity of 94.7% and 87.5%, a negative predictive value of 99.7% and 99.0%, a specificity of 39.5% and 33.0%, and a positive predictive value of 3.6% and 3.3%, respectively. In a multivariable model including age, sex, T2DM duration, albuminuria, uncontrolled systolic blood pressure, abnormal electrocardiogram and ischaemic heart disease for diagnosis of HF in patients reporting dyspnea, adding MR-proANP increased the area under the curve from 0.69 to 0.78 (P < 0.001). In conclusion, HFrEF was rare among outpatients with T2DM. MR-proANP rules out HFrEF and contributes independent information relevant to diagnosis of HF in patients reporting dyspnea.
KW - cardiovascular disease
KW - diabetes complications
KW - macrovascular disease
KW - type 2 diabetes
U2 - 10.1111/dom.13583
DO - 10.1111/dom.13583
M3 - Journal article
C2 - 30447033
AN - SCOPUS:85057994606
VL - 21
SP - 736
EP - 740
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
SN - 1462-8902
IS - 3
ER -
ID: 236017956