1317-P: The Use of NT-proBNP for Risk Stratification of Incident Cardiorenal Complications in Type 2 Diabetes—The Hong Kong Diabetes Biobank

NT-proBNP has emerged as a potential biomarker for cardiovascular complications. We examined the association between NT-proBNP with prevalent and incident diabetes complications, and compared it against prediction based on established risk equations. NT-proBNP was measured using an electrochemiluminescent immunoassay on a Roche cobas e411 analyzer in a subset of baseline samples from the Hong Kong Diabetes Biobank, a multi-centre prospective cohort of individuals with diabetes. All subjects underwent comprehensive assessment for diabetes complications, and were prospectively followed up. Among 1983 subjects with type 2 diabetes (60% male), mean age at recruitment was 61.1±11 years. At baseline, 24.7% of participants had NT-proBNP ≥125pg/ml. Those with NT-proBNP ≥125pg/ml had significantly higher SBP, lower eGFR, and a higher proportion had CHD, PVD and CHF at baseline (all p<0.001). In multivariate logistic regression adjusting for baseline age, sex, DM duration, smoking, BMI, waist, SBP, DBP, HbA1c, lipid traits, lnACR, eGFR and use of DM medications, NT-proBNP was associated with CVD and CKD at baseline. During median follow-up of 5.2 (5.0-5.4) years, baseline NT-proBNP (≥125 vs <125) was associated with increased risk of incident CVD with HR (95%CI) 2.34 (1.41, 3.89), CHF HR 2.60 (1.26, 5.37) and renal complications HR 1.88 (1.20, 2.96)(p <0.01). The cut-off of 125pg/ml showed good performance in differentiating between those with or without incident complications with C-index (95%CI) 0.82 (0.74, 0.89) for CHD, 0.87 (0.80, 0.94) for hospitalization with CHF and 0.86 (0.82, 0.90) for ESRD. Incorporating NT-proBNP improved prediction of CHD, CHF or ESRD compared to using the JADE risk equations alone. Our study highlights the utility of NT-proBNP for risk stratification of cardio-renal complications in T2DM. Disclosure R.C.W.Ma: Advisory Panel; AstraZeneca, Merck & Co., Inc., Other Relationship; Bayer Inc., Boehringer-Ingelheim, Research Support; Tricida, Inc., Roche Diagnostics, Novo Nordisk. C.K.P.Lim: Stock/Shareholder; GemVCare Ltd. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer Inc., Celltrion, Boehringer Ingelheim and Eli Lilly Alliance, Sanofi, Research Support; AstraZeneca, Servier Laboratories, Viatris Inc., Hua Medicine, Merck KGaA, Applied Therapeutics Inc., Lee Powder, Pfizer Inc., Speaker's Bureau; Novartis, Stock/Shareholder; GemVCare Ltd. The hong kong diabetes biobank study group: n/a. C.H.Tam: None. Y.Hou: None. Q.Jin: None. E.S.H.Lau: None. R.Ozaki: None. A.P.Kong: Advisory Panel; Abbott, Kyowa Kirin Co., Ltd., Speaker's Bureau; Abbott, AstraZeneca, Lilly, Bayer Inc., Boehringer Ingelheim Inc. E.Chow: Research Support; Medtronic, Merck KGaA, Speaker's Bureau; Novartis, Bayer Inc., Sanofi. A.Luk: Research Support; Novo Nordisk, Boehringer-Ingelheim, Bayer Inc., Speaker's Bureau; Eli Lilly and Company. Funding Roche Diagnostics (Hong Kong) Limited (to R.C.W.M.); Hong Kong Diabetes Biobank (CUR4012-18); Research Grants Council; (T12-402/13N); Croucher Foundation (to R.C.W.M.)