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NT-proBNP and Cardiovascular Disease risk reduction in CANVAS Study

NT-proBNP and Cardiovascular Disease risk reduction in CANVAS Study

Dr James Januzzi MD., Hutter Family Professor of Medicine at Harvard Medical School and Cardiologist at the Massachusetts General Hospital, talks about the main objectives and key findings from his research about NT-proBNP in Type 2 Diabetes patients (T2DM) conducted using the biorepository from the CANagliflozin cardioVascular Assessment Study (CANVAS) program.

In the CANVAS program, Canagliflozin, which is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that reduces blood glucose, as well as blood pressure, body weight, and albuminuria in T2DM patients, was found to reduce adverse cardiovascular events and had a particularly profound impact on heart failure events, including hospitalization.1 

This led to an interest in studying biomarkers and their potential to identify cardiovascular risk in T2DM patients as well as their potential to predict the benefits of Canagliflozin for these patients. 

The CANVAS study included NT-proBNP measurements, the gold-standard biomarker for detecting heart failure in patients, at baseline, 1 year and 6 years and was used to evaluate both of these theories.

One major finding from the research indicates that patients with T2DM are at high risk for the onset of heart failure and subsequent complications which usually go undetected. Another major finding showed that treatment with Canagliflozin lowered NT-proBNP concentrations at subsequent measurements. 

These findings imply a lowered risk of heart failure in the future and better quality of life for T2DM patients receiving treatment with Canagliflozin.

While Canagliflozin reduced the risk of cardiovascular events in patients across a wide spectrum in the CANVAS study, patients with elevated NT-proBNP levels (at baseline) had very large reductions in their risk of developing heart failure. 

This means that NT-proBNP can also be used to identify patients who would gain the most from being placed on a novel therapy like Canagliflozin.

References:

Cardiovascular Diabetology. (2019). https://cardiab.biomedcentral.com/articles/10.1186/s12933-019-0869-2 [Accessed April 19, 2021]

Key facts
  • Listen to Dr. James Januzzi as he gives us insights on his exciting research using NT-proBNP data from the CANVAS program.
  • This research sheds light on key questions about the use of biomarkers (NT-proBNP) for identifying the risk of developing cardiovascular diseases in type 2 diabetes (T2DM) patients and for evaluating the benefits of SGLT2 inhibitor therapy in these patients.
  • A major finding was the large percentage of T2DM patients in the CANVAS study that had an unrealized risk of developing heart failure.
  • Another major finding was the interesting effect of Canagliflozin treatment on NT-proBNP concentrations observed in subsequent measurements and which has implications for heart failure risk reductions in T2DM patients.
  • Findings from this research have major clinical implications for diagnosis of T2DM patients with heart failure and in deciding which patients would benefit the most from SGLT2 inhibitors therapy.
Elecsys® NT-proBNP

The gold standard biomarker in heart failure

Roche NT-proBNP

Electro-chemiluminescence immunoassay (ECLIA) for the in vitro quantitative determination of N-terminal pro B-type natriuretic peptide in human serum and plasma