June 20, 2019Open Access
Predictors of heart failure development in type 2 diabetes
Key Result
Routine clinical factors and natriuretic peptides can identify patients with type 2 diabetes at high risk for de novo heart failure who may benefit from preventive therapies like SGLT-2 inhibitors.
Structured PICO
Does risk stratification and targeted use of SGLT-2 inhibitors prevent de novo heart failure in patients with type 2 diabetes?
P
Population
Patients with type 2 diabetes without known heart failure
I
Intervention
Risk stratification using clinical factors and NT-proBNP, and initiation of SGLT-2 inhibitors
O
Outcome
Development of de novo heart failure
Routine clinical risk factors combined with NT-proBNP screening can identify patients with type 2 diabetes at high risk for de novo heart failure who may benefit from primary prevention with SGLT-2 inhibitors.
Limitations
- The clinical variables suggested for risk stratification have not been derived as part of a validated model.
Abstract
PURPOSE OF REVIEW: Although type 2 diabetes (T2D) is one of the most important risk factors that leads to the development of de novo heart failure, there are limited data, particularly from a practical/qualitative standpoint, about predictors of heart failure in this population. RECENT FINDINGS: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been shown to prevent the development of heart failure and the composite of heart failure and cardiovascular death in patients with T2D without known heart failure who have either established atherosclerotic vascular disease or multiple risk factors. The concept of primary prevention of heart failure has led many clinicians to inquire if there are specific risk/enrichment factors that may predict an increased risk of heart failure. SUMMARY: In this review, we identify some general and diabetes-specific risk factors that are associated with an increased risk of developing heart failure in people with T2D.