Relationship between the circulating N-terminal pro B-type natriuretic peptide and the risk of carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a CSCD-TCM plus study in China

Objective: Circulating N-terminal pro B-type natriuretic peptide(NT-proBNP) is often used as a marker of heart failure in patients with coronary heart disease (CHD), and it is associated with glycaemic abnormalities. Studies on the association and diagnostic value of NT-proBNP with carotid plaque (CAP) in patients with CHD are limited. Methods: This study included 5,093 patients diagnosed with CHD. Their NT-proBNP levels, blood glucose levels, the occurrence of CAP, and the number and nature of CAP were measured, and glucose metabolic status was defined as normoglycaemic (NG), prediabetes (Pre-DM), and diabetes mellitus (DM); logistic regression analyses were used to compare the relationship between NT-proBNP and the risk of CAP occurrence, and the number and nature of CAP. Patients were divided into three groups according to NT-proBNP tertiles. The diagnostic value of NT-proBNP for CAP risk was measured using ROC curves. There was a significant correlation between NT-proBNP and the risk of CAP in CHD patients in different glucose metabolic states. Results: Multiple logistic regression results showed that consecutive NT-proBNP was associated with risk of CAP progression. When NT-proBNP levels at T1 was used as the reference, T3 were associated with an increased OR for CAP (OR: 1.69; 95% CI: 1.37-2.10). This association was also present in the in both the pre-DM and DM states, which with the highest OR in the DM state (OR: 1.84; 95% CI: 1.26-2.69). This association was significant in DM status in men and pre-DM in women, and was significant in DM status in patients ≤60 years of age and in pre-DM and DM in patients >60 years of age. We also measured the diagnostic accuracy of CAP occurrence in NT-proBNP in CHD patients. The critical values were 182ng/l, with an AUC value of 0.627(95% CI: 0.592-0.631). Conclusion: The increase in NT-proBNP is significantly associated with the risk of CAP in patients with CHD, and exhibits specific characteristics under different glucose metabolism states, this association exists between different sexes and ages. Trial registration: The study was approved by the Ethics Committee of Tianjin University of Traditional Chinese Medicine (approval number TJUTCM-EC20210007) and certified by the Chinese Clinical Trials Registry on April 4, 2022 (registration number ChiCTR2200058296) and on March 25, 2022 by ClinicalTrials.gov (registration number NCT05309343).