In conclusion, our study demonstrates that MR-proANP levels were highly associated with incident cardiovascular events in outpatients with type 2 diabetes and that patients with HFpEF and high MR-proANP levels had a higher risk for cardiovascular events compared to patients with HFpEF without elevated MR-proANP and compared to patients without heart failure. This evidence concerns the gene NPPA and type 2 diabetes mellitus.