Cardiometabolic & kidneySecondary analysis
Intensive Lifestyle Intervention, Cardiac Biomarkers, and Cardiovascular Outcomes in Diabetes
- Secondary analysis of the Look AHEAD randomised trial
Authors' conclusion
Among adults with T2D, an ILI led to a significant reduction in hs-cTnT on follow-up but a transient increase in NT-proBNP levels at 1 year that attenuated over time. Longitudinal assessment of NT-proBNP and hs-cTnT provide prognostic information for ASCVD risk, whereas only changes in NT-proBNP predicted HF risk.
Study context
- Population
- Adults with T2DM in the Look AHEAD trialbaseline biomarker measurement
- Participants
- 3,984 adults
- Comparison
- Intensive lifestyle intervention (ILI) vs DSE
- Primary endpoint
- Effect of ILI on NT-proBNP and hs-cTnT (GMR); association of biomarker changes with CV outcomes
- Follow-up
- 1 and 4 years
Primary result
As reported in the abstract
NT-proBNP and hs-cTnT, ILI vs DSE
GMR
- NT-proBNP, 1 year
- 1.14 (95% CI 1.08–1.20)
- NT-proBNP, 4 years
- 1.01 (95% CI 0.96–1.07)
- High-sensitivity cardiac troponin T (hs-cTnT), 1 year
- 0.94 (95% CI 0.91–0.97)
- hs-cTnT, 4 years
- 0.93 (95% CI 0.90–0.96)
Further findings
Biomarkers by 1-year weight loss (≥5% vs <5%)
- ≥5% weight loss: significant NT-proBNP increase at year 1, attenuated by year 4
- ≥5% weight loss significantly associated with long-term hs-cTnT reduction
Biomarker changes and CV outcomes (adjusted Cox models)
- Increase in NT-proBNP significantly associated with higher risk of composite atherosclerotic cardiovascular disease (ASCVD) outcome and incident HF
- Increase in hs-cTnT significantly associated with higher risk of composite ASCVD outcome but not incident HF (most adjusted model)
Original publication
Intensive Lifestyle Intervention, Cardiac Biomarkers, and Cardiovascular Outcomes in Diabetes. J Am Coll Cardiol. Published 15 November 2024. doi:10.1016/j.jacc.2024.11.004
Summarised from the published abstract; every number is checked against it