PMID- 15451907
OWN - NLM
STAT- MEDLINE
DCOM- 20050211
LR  - 20190516
IS  - 0149-5992 (Print)
IS  - 0149-5992 (Linking)
VI  - 27
IP  - 10
DP  - 2004 Oct
TI  - The effect of diabetes on B-type natriuretic peptide concentrations in patients 
      with acute dyspnea: an analysis from the Breathing Not Properly Multinational 
      Study.
PG  - 2398-404
AB  - OBJECTIVE: Diabetes has been implicated in reduced myocardial compliance and 
      changes in the intercellular matrix of the myocardium. We determined the effect 
      of diabetes on B-type natriuretic peptide (BNP) concentrations in patients 
      presenting to the emergency department with dyspnea. RESEARCH DESIGN AND METHODS: 
      The Breathing Not Properly Multinational Study was a prospective evaluation of 
      1,586 patients. A subset of 922 patients was obtained and subdivided into the 
      following groups: group 1 (n = 324), neither diabetes nor heart failure; group 2 
      (n = 107), diabetes and no heart failure; group 3 (n = 247), no diabetes and 
      heart failure; group 4 (n = 183), both diabetes and heart failure; group 5 (n = 
      41), heart failure history with no diabetes; and group 6 (n = 20), heart failure 
      history with diabetes. Patients from groups 1, 3, and 5 were matched to groups 2, 
      4, and 6, respectively, to have the same mean age, sex distribution, BMI, renal 
      function, and New York Heart Association (NYHA) classification (for heart 
      failure). RESULTS: There was no significant difference in median BNP levels 
      between diabetes and no diabetes among no heart failure patients (32.4 vs.32.9 
      pg/ml), heart failure patients (587 vs. 494 pg/ml), and those with a heart 
      failure history (180 vs. 120 pg/ml). Receiver-operating characteristic curve 
      analysis of the area under the curve for BNP was not different in diabetic versus 
      nondiabetic patients (0.888 vs. 0.878, respectively). However, in a multivariate 
      model, diabetes was an independent predictor of a final diagnosis of heart 
      failure (odds ratio 1.51, 95% CI 1.03-2.02; P < 0.05). CONCLUSIONS: History of 
      diabetes does not impact BNP levels measured in patients with acute dyspnea in 
      the emergency department. Despite the impact of diabetes on the cardiovascular 
      system, diabetes does not appear to confound BNP levels in the emergency 
      department diagnosis of heart failure.
CI  - Copyright 2004 American Diabetes Association
FAU - Wu, Alan H B
AU  - Wu AH
AD  - Department of Pathology and Laboratory Medicine, Hartford Hospital, Connecticut, 
      USA. wualan@labmed2.ucsf.edu
FAU - Omland, Torbjorn
AU  - Omland T
FAU - Duc, Philippe
AU  - Duc P
FAU - McCord, James
AU  - McCord J
FAU - Nowak, Richard M
AU  - Nowak RM
FAU - Hollander, Judd E
AU  - Hollander JE
FAU - Herrmann, Howard C
AU  - Herrmann HC
FAU - Steg, Philippe G
AU  - Steg PG
FAU - Wold Knudsen, Cathrine
AU  - Wold Knudsen C
FAU - Storrow, Alan B
AU  - Storrow AB
FAU - Abraham, William T
AU  - Abraham WT
FAU - Perez, Alberto
AU  - Perez A
FAU - Kamin, Richard
AU  - Kamin R
FAU - Clopton, Paul
AU  - Clopton P
FAU - Maisel, Alan S
AU  - Maisel AS
FAU - McCullough, Peter A
AU  - McCullough PA
CN  - Breathing Not Properly Multinational Study Investigators
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Acute Disease
MH  - Age Factors
MH  - Area Under Curve
MH  - Biomarkers/analysis
MH  - Confidence Intervals
MH  - Diabetes Mellitus, Type 2/*diagnosis/epidemiology
MH  - Dyspnea/diagnosis/etiology
MH  - Emergency Service, Hospital
MH  - Female
MH  - Heart Failure/*diagnosis/epidemiology
MH  - Humans
MH  - Male
MH  - Multivariate Analysis
MH  - Natriuretic Peptide, Brain/analysis/*metabolism
MH  - Probability
MH  - Prognosis
MH  - Prospective Studies
MH  - Reference Values
MH  - Risk Assessment
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Sex Factors
EDAT- 2004/09/29 05:00
MHDA- 2005/02/12 09:00
CRDT- 2004/09/29 05:00
PHST- 2004/09/29 05:00 [pubmed]
PHST- 2005/02/12 09:00 [medline]
PHST- 2004/09/29 05:00 [entrez]
AID - 27/10/2398 [pii]
AID - 10.2337/diacare.27.10.2398 [doi]
PST - ppublish
SO  - Diabetes Care. 2004 Oct;27(10):2398-404. doi: 10.2337/diacare.27.10.2398.