Scans to screen all 40M Americans with diabetes for HF would be nearly impossible, but the TARTAN-HF trial may have found a more streamlined method by leveraging the cardiometabolic connection.
- One in five patients with diabetes have HF, reinforcing just how connected the two conditions are and their place in the cardiovascular-kidney-metabolic paradigm.
- But HF symptoms like swelling and fatigue overlap with diabetes and make the dual diagnosis harder to catch.
Which is why TARTAN-HF’s researchers created a targeted screening strategy.
- First, patients must have had an additional HF risk factor, like CAD or AFib.
- Then, clinicians tested if patients’ NT-proBNP levels were ≥125 pg/mL.
- If those conditions were met, an echocardiogram was ordered.
Spoiler alert: the method worked. Among 706 patients with diabetes randomized to usual care or the targeted screening…
- Symptomatic patients with unrecognized HF were almost 25x more likely to receive a diagnosis if they were in the screening group versus usual care (24.6% vs. 1%).
- HFpEF accounted for 93% of diagnoses, with HFmrEF/HFrEF making up the other 7%.
- SGLT2is use increased from 24% to 39% in the screening group.
That huge jump in successful screening is another example that shows the heart isn’t the sole contributor to CVD risk, a fact mirrored by the CKM guidelines released earlier this year.
- TARTAN illustrates how understanding the body-wide toll of diabetes as a clue to HF development can improve patients’ lives.
- That’s because more targeted screening could help catch more HF cases early.
- Finding HF early makes all the difference in survival and quality of life.
Still, TARTAN-HF’s results may not be generalizable to everyone due to some design limitations.
- The small Scotland-based study’s sample was 97% white.
- Prior research has found that circulating NT-proBNP levels can be naturally lower for other races and ethnicities.
- As such, more diverse studies would be needed to back up TARTAN’s method.
The Takeaway
TARTAN-HF is another example of how the CKM connection shows up in the real world. With a bolstered understanding of the connection between HF and diabetes, TARTAN’s targeted method may be just what the doctor ordered to improve screening and diagnose patients before it’s too late.
