A two-step screening strategy may help prevent heart failure in people with diabetes

A study conducted by researchers from UT Southwestern Medical Center Researchers evaluated a two-step screening protocol that combines clinical risk assessment and biomarker testing, and demonstrated that this strategy can more effectively identify patients with type 2 diabetes who need medication to prevent heart failure.

Currently, the relationship between diabetes and cardiovascular disease is well known among specialists in both fields, with heart failure being one of the most common manifestations, even in patients considered to be at low risk after one-step screening, through the use of a result Clinical risk assessment, vital signs testing, or echocardiography.

In this study, researchers were able to understand that combining these risk assessment strategies with a second step, such as analyzing natriuretic peptide (NT-proBNP) levels, is the most effective and cost-effective heart failure screening strategy. Low risk patients.

Natriuretic peptides, which are proteins produced by the heart in states of myocardial hemodynamic stress, are used as biomarkers of cardiovascular disease. Research into these biomarkers allows an early therapeutic approach, for example, using SGLT2 inhibitors, which are drugs with proven added value in the treatment of diabetes and the prevention of cardiovascular diseases.

To reach this conclusion, the researchers evaluated different two-step screening strategies, including 6,293 adult participants (48.2% women) with diabetes and no heart failure. “Participants without atherosclerotic cardiovascular disease who were at high risk of developing heart failure were identified through one-step screening strategies: a result Risk (WATCH-DM≥12); NT-proBNP ≥125 pg/ml; High-sensitivity cardiac troponin (hs-cTnT ≥14 ng/L, hs-cTnI≥31 ng/L); “Echocardiography-based diabetic cardiomyopathy,” they said, adding: “At-risk participants were identified using two-step screening strategies with a second test to further determine residual risk among those considered low risk by the first test: WATCH-DM/NT- proBNP, NT-proBNP/hs-cTn, NT-proBNP/eco-DbCM”.

The researchers conclude by saying: “Selective testing for NT-proBNP depends on… a result WATCH-DM has efficiently identified a population with high-risk primary prevention of diabetes in which significant absolute benefits would be expected from the use of SGLT2 inhibitors to prevent heart failure.

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