Background: Recent guidelines1,2 recommend yearly biomarker screening (BNP, NT-proBNP or hs-cardiac troponin) of patients with diabetes at-risk for heart failure (HF) and team-based care with a cardiovascular specialist if elevated1-3.
Methods: Using de-identified laboratory results from Labcorp® patients (2015-2022), we studied diabetes and HF ICD incidence via HbA1c and subsequent BNP/NT-proBNP (in pg/mL). Patients were classified as A1c consistent with no diabetes, prediabetes, or diabetes and newly diagnosed HF if they had no HF-associated ICD on/before date of initial HF testing and assigned one on a later date. Distribution of HF by cohort was evaluated by chi squared and likelihood by odds ratios (OR).
Results: There were 805,512 unique patients with A1c and either BNP/NT-proBNP performed. Using published cutoffs1-3, new diagnosis of HF by ICD was significantly different among cohorts for all cutoffs (p<0.001) and more likely in patients with diabetes compared to those without (OR 1.48 by BNP ≥ 35, 1.45 by BNP ≥ 50, 1.37 by NT-proBNP). As BNP cutoff increased, patients meeting criteria decreased. NT-proBNP > 125 had similar proportional yield of HF diagnosis to BNP ≥ 35.
Conclusion: Patients with diabetes (by A1c) were more likely to have a new diagnosis of HF on subsequent testing than patients without diabetes. The BNP cutoff utilized has meaningful implications for the number of patients referred to team-based care.
D.Alfego: Employee; LabCorp. A.Valcour: Employee; LabCorp. Z.Shajani-yi: Employee; LabCorp. R.M.Young: Employee; LabCorp. R.M.Sullivan: Employee; LabCorp.
