Epidemiology of heart failure in diabetes: a disease in disguise

Diabetologia, Journal Year: 2024, Volume and Issue: 67(4), P. 574 - 601

Published: Feb. 9, 2024

Abstract Left ventricular diastolic dysfunction (LVDD) without symptoms, and heart failure (HF) with preserved ejection fraction (HFpEF) represent the most common phenotypes of HF in individuals type 2 diabetes mellitus, are more than reduced (HFrEF), mildly (HFmrEF) left systolic (LVSD) these individuals. However, diagnostic criteria for have changed over years, resulting heterogeneity prevalence/incidence rates reported different studies. We aimed to give an overview diagnosis epidemiology diabetes, using both a narrative systematic review approach; we focus narratively on diagnosing (using 2021 European Society Cardiology [ESC] guidelines) screening diabetes. performed updated (2016–October 2022) meta-analysis studies reporting prevalence incidence subtypes adults ≥18 years echocardiographic data. Embase MEDLINE databases were searched data assessed random-effects meta-analyses, findings presented as forest plots. From 5015 found, 209 screened full-text article. In total, 57 included, together 29 that identified prior meta-analysis; LVSD ( n =25 studies, 24,460 individuals), LVDD =65 25,729 HFrEF =4 4090 HFmrEF =2 2442 individuals) and/or HFpEF =8 5292 =7 17,935 individuals). Using Hoy et al’s risk-of-bias tool, found included generally had high risk bias. They showed 43% (95% CI 37%, 50%) LVDD, 17% 7%, 35%) HFpEF, 6% 3%, 10%) LVSD, 7% 15%) HFrEF, 12% 22%) HFmrEF. For grade I was be prevalent. Additionally, higher rate (7% [95% 4%, 11%]) 4% 7%]). The evidence is limited by years. section this provides new insights unveiling large pre-clinical target group LVDD/HFpEF which disease progression could halted early recognition treatment. Registration PROSPERO ID CRD42022368035. Graphical

Language: Английский

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Diabetic myocardial disorder. A clinical consensus statement of the Heart Failure Association of the ESC and the ESC Working Group on Myocardial & Pericardial Diseases

European Journal of Heart Failure, Journal Year: 2024, Volume and Issue: unknown

Published: June 19, 2024

Language: Английский

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Evaluation of Pro‐BNP biomarker in heart failure patients and its relationship with complete blood count parameters: A case–control study

Health Science Reports, Journal Year: 2024, Volume and Issue: 7(9)

Published: Sept. 1, 2024

Abstract Background and aims Heart failure (HF) is a growing global health concern. N‐terminal prohormone of brain natriuretic peptide (NT‐pro‐BNP) an established biomarker for ventricular dysfunction in heart (HF). This case–control study examined the relationship between (Pro‐BNP) levels complete blood count (CBC) parameters HF patients healthy controls, exploring utility CBC as supplementary diagnostic tool HF. Methods The included 89 participants, divided into 42 with diagnosed (patient group) 47 individuals (control group). Pro‐BNP were measured alongside comprehensive panel, including such white cell count, hemoglobin levels, platelet count. Demographic, clinical characteristics, compared two groups, statistical analyses performed to identify any significant associations. Results analysis demonstrated that had significantly higher than control subjects, indicating strong association (1052.65 [196.56] vs. 2500.34 [1105.90], p < 0.001). Moreover, differences parameters, count: 246.96 (82.72) versus 206.45 (57.20), = 0.009; mean corpuscular volume (MCV): 83.74 (5.86) 87.12 (4.60), 0.00; red distribution width: 13.47 (1.29) 14.28 (1.35), 0.001) observed, patient group showing altered indicative cardiac stress inflammation. Correlation further notable correlations observed MCV (0.250, 0.020) (0.246, 0.045). These findings suggest complex interplay underscoring potential auxiliary markers Conclusion exhibits relevance diagnosing cardiovascular dysfunction, elevated distinct hematological profiles patients. Pro‐BNP's predictive capabilities hematocrit support its use risk assessment treatment decisions

Language: Английский

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Independent and joint associations between the triglyceride-glucose index and NT-proBNP with the risk of adverse cardiovascular events in patients with diabetes and acute coronary syndrome: a prospective cohort study

Cardiovascular Diabetology, Journal Year: 2023, Volume and Issue: 22(1)

Published: June 26, 2023

Abstract Background Elevated triglyceride-glucose (TyG) index and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are independently associated with increased risk of major adverse cardio-cerebral events (MACCEs) in diabetic patients the acute coronary syndrome (ACS), but have not been evaluated jointly. We sought to investigate independent joint association TyG NT-proBNP MACCEs risk. Methods Data from 5046 diabetes ACS were recorded Cardiovascular Center Beijing Friendship Hospital Database Bank between 2013 2021, including measurements fasting triglycerides, plasma glucose, NT-proBNP. The was calculated as Ln (fasting triglycerides [mg/dL] × glucose [mg/dL]/2). Associations assessed using flexible parametric survival models. Results During 13589.9 person-years follow-up, 985 incident (65.6 years age 62.0% men) observed. (HR: 1.18; 95% CI 1.05‒1.32 per 1 unit increase) categories 1.95; CI: 1.50‒2.54 for > 729 pg/ml compared < 129 pg/ml) fully adjusted model. According NT-proBNP, 9.336 at highest 2.45; 1.64‒3.65) than ones 8.746 pg/ml. test interaction significant ( P = 0.49). Incorporating these two biomarkers into established clinical model, Global Registry Acute Coronary Events (GRACE) score, resulted a improvement stratification. Conclusions jointly ACS, suggesting that both markers elevated should be aware higher future.

Language: Английский

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Distribution characteristics and screening reference values of NT-proBNP in high cardiovascular risk population

Nutrition Metabolism and Cardiovascular Diseases, Journal Year: 2025, Volume and Issue: unknown, P. 104029 - 104029

Published: April 1, 2025

Language: Английский

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Development and validation of a machine learning model for online predicting the risk of in heart failure: based on the routine blood test and their derived parameters

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 12

Published: March 17, 2025

Heart failure (HF), a core component of cardiovascular diseases, is characterized by high morbidity and mortality worldwide. By collecting analyzing routine blood data, machine learning models were built to identify the patterns changes in indicators related HF. We conducted statistical analysis data from 226 patients who visited Zhejiang Provincial Hospital Traditional Chinese Medicine (Hubin) between May 1, 2024, June 30, 2024. The divided into an experimental group (HF patients) normal control group. Additionally, 211 Qiantang Xixi centers formed independent external validation cohort. This study used both univariate multivariate analyses risk factors associated with Variables HF selected using LASSO regression analysis. In addition, eight different algorithms applied for prediction, prediction performances these comprehensively evaluated receiver operating characteristic curve, area under curve (AUC), calibration analysis, decision confusion matrix. Using leukocyte, neutrophil, red cell, hemoglobin, platelet, monocyte-to-lymphocyte ratios identified as Among models, random forest model exhibited best performance. cohort, (AUC) was 0.948, while that test cohort 1.000. revealed good agreement actual predicted probabilities, whereas showed significant clinical application model. AUC 0.945. online predictive tool develop machine-learning main purpose this predict probability developing future. can provide strong support references clinicians when making decisions. forecasting not only processes large amount but also continuously optimizes adjusts accuracy according latest medical research data. hope high-risk early intervention reduce incidence improve their quality life.

Language: Английский

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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

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Aug. 12, 2024

Abstract Background We evaluated the prevalence of “heart stress” (HS) based on NT-proBNP cut-points proposed by 2023 Consensus Heart Failure Association (HFA) European Society Cardiology (ESC) in asymptomatic patients with T2DM and hypertension or high-normal blood pressure (BP) eligible for SGLT2 inhibitors (SGLT2i) and/or GLP-1 receptor agonists (GLP1-RA), drugs proven benefits reducing incidence HF, hospitalizations, cardiovascular events mortality. Methods A cross-sectional multicentric study was conducted 192 consecutive outpatients, aged ≥ 55 years, BP, referred to three diabetology units. collected before starting new anti-diabetic therapy. Patients known HF were excluded, participants classified age-adjusted cut-points. Results Mean age: 70.3 ± 7.8 years (67.5% males). obesity (BMI 30 Kg/m 2 ): 63.8%. Median NT-proBNP: 96.0 (38.8–213.0) pg/mL. Prevalence chronic kidney disease (CKD, eGFR < 60 mL/min/1.73m 32.1%. arterial BP: 138.5/77.0 15.8/9.9 mmHg. The values, according cut-points, 28.6% as “HS likely” (organize elective echocardiography specialist evaluation), 43.2% not (a grey area, repeat at six months) 28.2% “very unlikely HS” (repeat one year). presence CKD number anti-hypertensive drugs, but glycemic parameters, independently associated HS. Conclusions According NT-proBNP, over a quarter hypertension/high-normal among those SGLT2i GLP1-RA, already risk cardiac damage, even subclinical. Most would receive an indication echocardiogram be specialist, allowing early implementation effective strategies prevent delay progression advanced stages overt HF.

Language: Английский

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Prehospital Targeting of 1-Year Mortality in Acute Chest Pain by Cardiac Biomarkers

Diagnostics, Journal Year: 2023, Volume and Issue: 13(24), P. 3681 - 3681

Published: Dec. 16, 2023

The identification and appropriate management of patients at risk suffering from acute chest pain (ACP) in prehospital care are not straightforward. This task could benefit, as occurs emergency departments (EDs), cardiac enzyme assessment. aim the present work was to derive validate a scoring system based on troponin T (cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), D-dimer predict 1-year mortality with ACP. prospective, multicenter, ambulance-based cohort study adult ACP diagnosis who were evacuated by ambulance ED between October 2019 July 2021. primary outcome 365-day cumulative mortality. A total 496 fulfilled inclusion criteria. rate 12.1% (60 patients). scores derived cTnT, NT-proBNP, presented an AUC 0.802 (95% CI: 0718-0.886) for superior that each individual enzyme. Our provides promising evidence predictive value score prediction implementation this has potential benefit medical service facilitate on-scene decision-making process.

Language: Английский

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Screening For Occult Heart Failure in Type 2 Diabetes Mellitus Using NT-proBNP: Real-World Evidence From a Tertiary Care Center in India

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 28, 2024

Objective Heart failure (HF) is an important underrecognized complication of type 2 diabetes mellitus (T2DM). Recent literature and recommendations support screening for HF among T2DM people attending the outpatient department (OPD) in non-emergency settings using a biomarker. The present study retrospective cross-sectional that assesses prevalence screen positivity (S+) undiagnosed (with normal electrocardiogram (ECG) no history heart disease) OPD at tertiary care center India N-terminal pro-B-type natriuretic peptide (NT-proBNP). It also highlights risk factors S+ HF. Methods This practice NT-proBNP to diagnose stage B A total 1,049 consecutive with (age range: 18-75 years) institute were screened (cut off >125 pg/mL). Demographic variables, vitals, smoking status, family history, status hypertension, medications diabetes, glycemic control recorded correlated Results Of T2DM, 336 (32.03%) had Those higher age (62.5+9.3 vs 54.2 +10.6 years), longer duration (14.4 +7.8 9.6 +6.1 positive (94 [28%] 55 [7.7%]) tobacco chewing (66 [19.6%] 24 [3.4%]), blood pressures (both systolic [152.1+19.9 134.6 +15 mmHg] diastolic [87.7+9.6 83.9+7.8 mmHg]), glycated hemoglobin (HbA1c) (8.4+1.4 7.6+1 BMI (28.3+2.8 27.2+2.1 kg/m

Language: Английский

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Irisin Predicts Poor Clinical Outcomes in Patients with Heart Failure with Preserved Ejection Fraction and Low Levels of N-Terminal Pro-B-Type Natriuretic Peptide

Biomolecules, Journal Year: 2024, Volume and Issue: 14(12), P. 1615 - 1615

Published: Dec. 17, 2024

Background: Despite existing evidence of the high predictive value natriuretic peptides (NPs) in patients with heart failure (HF), treated guideline-directed therapy who have low or near-normal NP levels are unlikely to be correctly stratified for risk clinical outcomes. The aim this study is detect plausible predictors poor one-year outcomes HFpEF and NT-proBNP accordance conventional guidelines. Methods: A total 337 HF preserved ejection fraction (HFpEF) had N-terminal pro-peptide (NT-proBNP) at discharge due optimal guideline-based were enrolled study. course observation was 3 years. Echocardiography assessment hematological biochemical parameters, including NT-proBNP, tumor necrosis factor-alpha, high-sensitivity C-reactive protein (hs-CRP), adropin, irisin, visfatin, fetuin-A, performed baseline end Results: Three-year cumulative endpoints (cardiovascular death, myocardial infarction unstable angina acute coronary syndrome, worsening HF, sudden cardiac cardiac-related surgery all-cause death) detected 104 patients, whereas 233 did not meet endpoint. After adjusting an age ≥ 64 years a presence atrial fibrillation, diabetes mellitus, chronic kidney disease (CKD) stages 1–3 dilated cardiomyopathy, multivariable Cox regression analysis showed that irisin level ≤7.2 ng/mL independent predictor Moreover, > 7.2 better Kaplan–Meier survival rate than those lower serum (≤7.2 ng/mL). Conclusions: Multivariable years; CKD cardiomyopathy; LAVI 39 mL/m2; hs-CRP 6.10 mg/L, ≤ ng/mL, visfatin 1.1 NT-proBNP. could emerge as valuable biomarker predicting long-term prognosis among

Language: Английский

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