Second, the increasingly intensive treatment used today in our patients is likely to have influenced the results compared to the earlier study, although in the Steno 2 multifactorial intervention study, P-NT-proBNP remained a strong independent predictor of CV mortality and here NT-proBNP levels also increased over time in the intervention group [23].Third, other factors than atherosclerosis per se, e.g., cardiac autonomic neuropathy or echo abnormalities are likely to influence CV mortality. Here, NPPB is linked to atherosclerosis.