ROLE OF BNP AS A SCREENING TOOL TO IDENTIFY ASYMPTOMATIC CARDIAC DISEASE IN TYPE 2 DIABETIC PATIENTS.

Background:-Diabetic adults have increased risk of mortality from atheroscelortic heart diseases compared to non diabetic humans. Routinely these patients have a increased new cases of cardiac failure and the unfavourable outcome of diabetes on cardiac failure, might worsening reflect an underlying diabetic cardiomyopathy aggrevated by coronary artery disease and left ventricular hypertrophy unidentified and untreated cases until advanced disease causes disability.this detain could be avoided if investigating techniques could be utilised to identify silent ischemia in its preclinical phase Aims and objectives:-Bnp as a screening tool to identify silent myocardial ischemia in asymptomatic type 2 diabetic patients. The objective of the study is how bnp value will be useful in early detection of myocardial ischemia without subjecting the patient to tmt.our effort is to identify a simple blood test which is highly sensitive in identifying myocardial ischemia. Methods:-A total of 100 patients in our out patient department of general medicine with type 2 diabetic patients were taken up for study,their fasting and post prandial blood sugar,fasting lipid profile,renal function test, liver function test,bnp values checked and tmt results were reported.their bnp and tmt reports were analysed and compared statistically. Results:-Out of 100 diabetic patients 22 patients had ischemia in tmt ,remaining 78 patients had negative results in tmt. The results reveal that bnp, tgl and total cholesterol are better model in detecting asymptomatic cardiac diseaseamong type 2 diabetic patients in complement to tmt method. The cut-off value 760 yield a sensitivity of 100 and false positive rate (1-specificity) 2.6bnp with cut-off value at 760 can be administered in detecting asymptomatic cardiac disease in complement to tmt with sensitivity 100 and false positive rate 2. 6 Conclusion:-This study shows a clear correlation between occurrence of increase in ischemia with increase in nt pro bnp concentration. Furthermore,the results suggest that ntprobnp value above 760 pg/ml is a good indicator for referring a patient for exercise tolerance test.we conclude that a single measurement of nt pro bnp at the diabetic opd can provide important information about the cardiac status of asymptomatic diabetic patients who might require a cardiac evaluation.early diagnosis of cardio vascular complications with the simple blood test would help preventing and reducing mortality and morbidity in diabetic patients