Protein Biomarkers and Cardiovascular Outcomes in People With Type 2 Diabetes and Acute Coronary Syndrome: The ELIXA Biomarker Study

Diabetes Care. 2022 Sep 1;45(9):2152-2155. doi: 10.2337/dc22-0453.

Abstract

Objective: To use protein biomarkers to identify people with type 2 diabetes at high risk of cardiovascular outcomes and death.

Research design and methods: Biobanked serum from 4,957 ELIXA (Evaluation of Lixisenatide in Acute Coronary Syndrome) trial participants was analyzed. Forward-selection Cox models identified independent protein risk factors for major adverse cardiovascular events (MACE) and death that were compared with a previously validated biomarker panel.

Results: NT-proBNP and osteoprotegerin predicted both outcomes. In addition, trefoil factor 3 predicted MACE, and angiopoietin-2 predicted death (C = 0.70 and 0.79, respectively, compared with 0.63 and 0.66 for clinical variables alone). These proteins had all previously been identified and validated. Notably, C statistics for just NT-proBNP plus clinical risk factors were 0.69 and 0.78 for MACE and death, respectively.

Conclusions: NT-proBNP and other proteins independently predict cardiovascular outcomes in people with type 2 diabetes following acute coronary syndrome. Adding other biomarkers only marginally increased NT-proBNP's prognostic value.

Trial registration: ClinicalTrials.gov NCT01147250.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome* / etiology
  • Biomarkers
  • Diabetes Mellitus, Type 2* / complications
  • Humans
  • Natriuretic Peptide, Brain
  • Peptide Fragments
  • Prognosis
  • Risk Assessment
  • Risk Factors

Substances

  • Biomarkers
  • Peptide Fragments
  • Natriuretic Peptide, Brain

Associated data

  • ClinicalTrials.gov/NCT01147250
  • figshare/10.2337/figshare.20069549