Annual HF testing in diabetes: New rec
Heart failure classification includes stage A, which is people who are at risk for developing heart failure. That's essentially everyone with diabetes. Stage B, which is our focus today, can be thought of as presymptomatic heart failure or pre–heart failure. These are people who have anwith evidence of structural heart disease, abnormal cardiac function, or elevated natriuretic peptide or cardiac troponin levels.
The reason for these new guidelines is recent good randomized trial evidence showing that appropriate treatment of people at risk for heart failure who have elevated NT-proBNP levels can reduce the risk for left ventricular dysfunction, newly diagnosed heart failure, and heart failure hospitalization.
That leads to the main recommendation of this consensus statement: annual testing of brain natriuretic peptide , NT-proBNP, or high-sensitivity cardiac troponin to identify the presence of stage B heart failure. The cutoff value for BNP is 50 pg/mL, and for NT-proBNP, it is 125 pg/mL. Patients who are identified in this manner should receive an echocardiogram and then, based on the results of the echo, be treated with appropriate medications that include renin-angiotensin system blockade , a sodium-glucose co-transporter 2 inhibitor, and other medications per the AHA/ACC heart failure guidelines, summarizedThese are big, important new recommendations that are easy to implement and have the potential to make a big difference for our patients with diabetes.