Screening Natriuretic Peptide Levels Predicts Heart Failure and Death in Individuals With Type 1 and Type 2 Diabetes Without Known Heart Failure
Authors' conclusion
Increased NP levels among individuals with diabetes are highly prognostic for future risk of HF or mortality. These findings support the implementation of NP screening for HF risk assessment in people with diabetes.
Study context
- Population
- Adults (≥18 years) with T1D or T2D without known heart failure (HF) who received an outpatient NP test, 2017–2023; 54% female, median age 64 years, mean HbA1c 7.1%2,990 T1D
- Participants
- 116,466 adults
- Exposure
- N-terminal pro-brain natriuretic peptide (NT-proBNP) levels 125-300 pg/mL and >300 pg/mL vs <125 pg/mL
- Outcome
- Incident HF or death
- Follow-up
- Up to 7 years
Methodological detailsde-identified claims/EHR data (Optum Market Clarity), multivariable Cox proportional hazard models
- De-identified claims/EHR data (Optum Market Clarity)
- Multivariable Cox proportional hazard models
Main finding
As reported in the abstract
Incident HF or mortality, adjusted HR by NT-proBNP level
Each group vs NT-proBNP <125 pg/mLHazard ratio (95% CI)
NT-proBNP 125-300 pg/mLT1D
2.04(1.35–3.07)
NT-proBNP >300 pg/mLT1D
4.48(3.11–6.47)
NT-proBNP 125-300 pg/mLT2D
1.85(1.74–1.97)
NT-proBNP >300 pg/mLT2D
3.58(3.39–3.78)
Observational data: associations, not effects.
Further findings
BNP ≥50 pg/mL or NT-proBNP ≥125 pg/mL (prevalence) · baseline
- T1D
- ≈39.6%
- T2D
- 42.3%
BNP and incident HF or mortality
- Similar findings were observed for BNP
Original publication
Screening Natriuretic Peptide Levels Predicts Heart Failure and Death in Individuals With Type 1 and Type 2 Diabetes Without Known Heart Failure. Diabetes Care. Published 30 October 2025. doi:10.
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