Serial assessment of NT-proBNP and high-sensitivity cardiac troponin with glucagon-like peptide-1 receptor agonist therapy in type 2 diabetes: Insights from EXSCEL.
Am Heart JMay 6, 2026 (epub)
Veraprapas Kittipibul, Maggie Nguyen, Paul Welsh et al.
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In 30 seconds
This randomized controlled trial from the EXSCEL study evaluated the prognostic value of NT-proBNP and high-sensitivity cardiac troponin I in 4,292 adults with type 2 diabetes receiving exenatide or placebo. It found that baseline NT-proBNP was a strong predictor of major adverse cardiovascular events (MACE) and mortality, with a hazard ratio of 1.63 for MACE per 1 unit increase.
Key findings
- Baseline NT-proBNP was prognostic for MACE (HR 1.63), all-cause mortality (HR 1.85), CV death (HR 2.17), and hHF (HR 2.17).
- A 1-year increase in NT-proBNP predicted later MACE (HR 1.85) and CV death (HR 2.81).
- Higher baseline cTnI concentrations were associated with lower rates of CV deaths and hHF with exenatide.
Why it matters
Understanding the prognostic value of cardiac biomarkers like NT-proBNP and cTnI can help clinicians better assess cardiovascular risk in patients with type 2 diabetes, potentially guiding treatment decisions and monitoring.