Detecting heart stress using NT-proBNP in patients with type 2 diabetes mellitus and hypertension or high-normal blood pressure: a cross-sectional multicentric study
Authors' conclusion
According to NT-proBNP, over a quarter of T2DM patients with hypertension/high-normal BP, among those eligible for SGLT2i and/or GLP1-RA, were already at risk of cardiac damage, even subclinical. Most would receive an indication to echocardiogram and be referred to a specialist, allowing the early implementation of effective strategies to prevent or delay the progression to advanced stages of cardiac disease and overt HF.
Study context
- Population
- Asymptomatic outpatients aged ≥55 years with T2D and hypertension or high-normal blood pressure (BP), eligible for SGLT2 inhibitors (SGLT2i) and/or GLP-1 RA, without known HF, referred to three diabetology units
- Participants
- 192 outpatients
- Outcome
- Prevalence of heart stress (HS) by age-adjusted NT-proBNP cut-points of the 2023 HFA-ESC Consensus
Methodological detailsmulticentric, consecutive outpatients, NT-proBNP collected before starting new anti-diabetic therapy
- Multicentric
- Consecutive outpatients
- NT-proBNP collected before starting new anti-diabetic therapy
Main finding
As reported in the abstract
Heart stress (HS) likely (elective echocardiography and specialist evaluation)
28.6%
HS not likely (grey area, repeat NT-proBNP at 6 months)
43.2%
Very unlikely HS (repeat NT-proBNP at 1 year)
28.2%
Observational data: associations, not effects.
Further findings
Factors associated with HS
- Chronic kidney disease (CKD) and number of anti-hypertensive drugs, but not glycemic parameters, independently associated with HS
Baseline characteristics
- Mean age (years)
- 70.3 ± 7.8
- Males
- 67.5%
- Obesity (BMI ≥ 30 Kg/m²)
- 63.8%
- Median NT-proBNP (pg/mL)
- 96.0 (38.8-213.0)
- CKD (eGFR < 60 mL/min/1.73m2)
- 32.1%
- Mean arterial BP (mmHg)
- 138.5/77.0 ± 15.8/9.9
Original publication
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