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To support the use of NT-proBNP to better detect heart failure in patients with type 2 diabetes

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Abstract

Purpose

Heart failure (HF) is a chronic disease that causes approximately 300,000 and 250,000 deaths per year in Europe and United States, respectively. Type 2 Diabetes Mellitus (T2DM) is one the major risk factors of HF, and the investigation of NT-proBNP might support the early identification of HF in T2DM sufferers. Nevertheless, this parameter is poorly investigated. Thus, we aimed to demographically and clinically characterize diabetic patients which were prescribed with NT-proBNP in the primary care setting.

Methods

Using a primary care database, we formed a cohort of patients aged ≥18 years diagnosed with T2DM between 2002 and 2021. A multivariate Cox model was adopted to assess the determinants associated with the prescription of NT-proBNP.

Results

Among 167,961 T2DM patients, 7558 (4.5%, 95% CI: 4.4–4.6) were prescribed with NT-proBNP. Males and increasing age were expectedly associated with a higher propensity to be prescribed with NT-proBNP. In addition, a significant association was found for those suffering from obesity, ischemic cardiomyopathy, stroke, atrial fibrillation, hypertension, and with a Charlson Index of 2+.

Conclusion

These determinants might contribute to investigate the NT-proBNP in T2DM sufferers. A decision support system to appropriately ease the prescription of NT-proBNP might be therefore implemented in primary care settings.

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Fig. 1

Data availability

The HSD analysed during the current study is owned by the Italian College of General Practitioners and Primary Care (SIMG), which is not authorised to make the datasets publicly available.

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Author contributions

F.L., E.M., C.P., conceived and designed the research and performed statistical and other analyses and drafted the manuscript. G.M., D.P., A.P.M. and C.C. drafted and critically revised the manuscript. All authors approved the final version before submission.

Funding

This work was supported by an unconditional grant from Roche Diagnostics.

Author information

Authors and Affiliations

  1. Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy

    Francesco Lapi & Ettore Marconi

  2. Italian College of General Practitioners and Primary Care, Florence, Italy

    Gerardo Medea, Damiano Parretti & Claudio Cricelli

  3. Fondazione ReS (Ricerca e Salute—Health and Research Foundation), Rome, Italy

    Carlo Piccinni & Aldo Pietro Maggioni

  4. ANMCO Research Center Heart Care Foundation, Florence, Italy

    Aldo Pietro Maggioni

Authors
  1. Francesco Lapi
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  2. Ettore Marconi
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  3. Gerardo Medea
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  4. Damiano Parretti
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  5. Carlo Piccinni
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  6. Aldo Pietro Maggioni
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  7. Claudio Cricelli
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Corresponding author

Correspondence to Francesco Lapi.

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Conflict of interest

F.L. and E.M. provided consultancies in protocol preparation for epidemiological studies and data analyses for Roche Diagnostics, Astra Zeneca, Novartis, MSD. G.M., D.P. and C.C. provided clinical consultancies for Roche Diagnostics, Astra Zeneca, Novartis, MSD. A.P.M. received personal fees for the participation in clinical studies supported by Bayer, Novartis, Fresenius and Astra Zeneca, outside the present work. C.P. has no conflict of interest to disclose.

Ethics

The study protocol was approved by the Scientific Committee of the Italian College of General Practitioners and Primary Care. This study followed the principles of the Declaration of Helsinki, and it is compliant with the ENCePP (European Network of Centers for Pharmacoepidemiology and Pharmacovigilance) Guide on Methodological Standards in Pharmacoepidemiology. Furthermore, as this is a retrospective, non‐interventional, observational study, the data were fully anonymized. There is therefore no need for informed consent (Italian Drug Agency note dated 3rd of August 2007).

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Lapi, F., Marconi, E., Medea, G. et al. To support the use of NT-proBNP to better detect heart failure in patients with type 2 diabetes. Endocrine 82, 42–46 (2023). https://doi.org/10.1007/s12020-023-03419-2

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  • DOI: https://doi.org/10.1007/s12020-023-03419-2

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