Sex differences in the diagnostic algorithm of screening for heart failure by symptoms and NT-proBNP in patients with type 2 diabetes
Authors' conclusion
These findings suggest that NYHA classification may not be the most suitable tool for assessing the diagnosis of HF in female patients with T2D. Moreover, the need for consideration of a more symptom-independent screening for HF in female patients with T2D and re-evaluation of current guidelines especially regarding sex-specific aspects is highlighted.
Study context
- Population
- Patients with T2D
- Participants
- 2,083 patients
- Exposure
- Women vs men: NYHA classification and NT-proBNP for heart failure (HF) diagnosis
- Outcome
- HF during hospitalization
- Follow-up
- Within a 5-year timeframe
Main finding
As reported in the abstract
HF diagnosis by NYHA class
- In women, frequency of HF diagnosis prior to or during hospitalization did not differ significantly between NYHA II and III, in contrast to men
- On multivariable Cox regression, NYHA score was no significant risk factor for HF in women
Observational data: associations, not effects.
Secondary outcomes
All-cause death by NYHA class
- In women, mortality did not differ significantly between NYHA II and III, in contrast to men
Mean NT-proBNP by NYHA class
- No notable difference in mean NT-proBNP between NYHA II and III only in women
- On multivariable regression, NYHA class predicted NT-proBNP in men but not in women
Mortality by NT-proBNP 125–400 pg/ml vs <125 pg/ml
- Men: no significant difference in mortality
- Women: mortality significantly higher with NT-proBNP 125–400 pg/ml than <125 pg/ml
Original publication
Sex differences in the diagnostic algorithm of screening for heart failure by symptoms and NT-proBNP in patients with type 2 diabetes. Cardiovasc Diabetol. Published 1 August 2024. doi:10.
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