Key Takeaways
- Residual cardiorenal risk persists in diabetes despite modern therapies, and traditional risk scores underperform in Asian populations, limiting effective identification of high-risk patients. [1,2]
- NT-proBNP provides a powerful precision-prognostic signal, reflecting early cardiac stress and outperforming conventional risk markers in predicting cardiovascular and renal outcomes in PwD. [3]
- Elevated NT-proBNP (≥125 pg/mL) identifies patients at high cardiorenal risk, with strong discrimination for CHD, HF, kidney failure, and mortality in real-world Asian cohorts. [4]
- Integrating NT-proBNP into routine diabetes assessment enables actionable risk stratification, supporting earlier intervention, personalized management, and improved adoption in clinical practice.[4]
This section presents a concise, high-yield summary of the video’s core content, designed as a quick reference for Healthcare Professionals (HCPs).
Note: This content was developed by our editorial team and was not reviewed or endorsed by the video speaker.
Q1. What unique information is NT-proBNP providing about cardiorenal risk that conventional metabolic biomarkers are missing?
Unlike HbA1c or albuminuria, which signal metabolic or renal injury after onset, NT-proBNP is cardiac-specific and reflects hemodynamic stress at a subclinical stage, predicting both cardiovascular and renal events before overt dysfunction appears. [5]
Q2. How was NT-proBNP integrated into the JADE Risk Scores?
NT-proBNP was applied to existing JADE Risk Scores for coronary heart disease, congestive heart failure, and kidney failure, respectively. This combination had improvedthe prediction of clinical events in people with type 2 diabetes. Such enhanced stratification could potentially help identify high-risk individuals who may benefit from more intensive therapies. [4]
Q3. Is the single cut-off of NT-proBNP≥125 pg/mL sufficient to define “elevated” cardiorenal risk across the type 2 diabetes population?
Yes. Although factors such as age, female sex, and renal insufficiency naturally elevate NT-proBNP, the 125 pg/mL cut-off demonstrated good discriminative ability for cardiorenal events, supporting its use as a practical, simplified cut-off for routine clinical adoption. [6]
References
- Basu S, Sussman JB, Berkowitz SA, Hayward RA, Yudkin JS. Development and validation of Risk Equations for Complications Of type 2 Diabetes (RECODe) using individual participant data from randomised trials. Lancet Diabetes Endocrinol. 2017;5(10):788-798. doi:10.1016/S2213-8587(17)30221-8
- RECODeRisk Equations; https://www.dtu.ox.ac.uk/riskengine/
- Huelsmann M, Neuhold S, Strunk G, et al. NT-proBNP has a high negative predictive value to rule-out short-term cardiovascular events in patients with diabetes mellitus. Eur Heart J. 2008;29(18):2259-2264. doi:10.1093/eurheartj/ehn334
- Ma RCW. Hong Kong Med Diary. 2024;29(6):4-8. Available at https://www.fmshk.org/database/hkmd/mdjun2024.pdf
- Neuhold S, Resl M, Huelsmann M, et al. Repeat measurements of glycated haemoglobin A(1c) and N-terminal pro-B-type natriuretic peptide: divergent behaviour in diabetes mellitus. Eur J Clin Invest. 2011;41(12):1292-1298. doi:10.1111/j.1365-2362.2011.02539.x
- Ma RCW, Tam CHT, Hou Y, et al. NT-proBNP improves prediction of cardiorenal complications in type 2 diabetes: the Hong Kong Diabetes Biobank. Diabetologia. 2025;68(2):342-356. doi:10.1007/s00125-024-06299-x