Assessing the risk of heart failure in type 2 diabetes: a prediction algorithm to sustain the evaluation of NT-proBNP in primary care.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2025-01-12 DOI:10.1007/s12020-024-04157-9

Francesco Lapi, Ettore Marconi, Gerardo Medea, Iacopo Cricelli, Damiano Parretti, Alessandro Rossi, Claudio Cricelli

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引用次数: 0

Abstract

Purpose: Heart failure (HF) is a disease that leads to approximately 300,000 fatalities annually in Europe and 250,000 deaths each year in the United States. Type 2 Diabetes Mellitus (T2DM) is a significant risk factor for HF, and testing for N-terminal (NT)-pro hormone BNP (NT-proBNP) can aid in early detection of HF in T2DM patients. We therefore developed and validated the HFriskT2DM-HScore, an algorithm to predict the risk of HF in T2DM patients, so guiding NT-proBNP investigation in a primary care setting.

Methods: Using a primary care database, we formed a cohort of patients aged ≥18 years diagnosed with T2DM between 2002 and 2022. A multivariate Cox model was adopted to assess the determinants associated with the occurrence of HF to combine them to form an individual score.

Results: Within a cohort of 167,618 patients (52.3% males; mean age 64.4 (SD: 14.4); HF rate equal to 6.7 cases per 1000 person-years), we developed the HFriskT2DM-HScore. When it was applied to the validation sub-cohort we found an explained variation and discrimination value of 43% (95% CI: 42-44) and 81% (95% CI: 0.80-0.83), respectively. Calibration slope was equal to 0.93 (95% CI: 0.81-1.1; p = 0.3123).

Conclusion: The HFriskT2DM-HScore might be implemented as a decision support system for primary care to appropriately ease the prescription of NT-proBNP and early identification of HF.

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评估 2 型糖尿病患者心力衰竭的风险：一种预测算法，用于支持在初级保健中对 NT-proBNP 进行评估。

目的：心力衰竭（HF）是一种疾病，在欧洲每年导致大约30万人死亡，在美国每年导致25万人死亡。2型糖尿病（T2DM）是HF的重要危险因素，检测n端（NT）前体激素BNP （NT- probnp）有助于早期发现T2DM患者的HF。因此，我们开发并验证了HFriskT2DM-HScore，这是一种预测T2DM患者HF风险的算法，可以指导初级保健机构的NT-proBNP调查。方法：使用初级保健数据库，我们在2002年至2022年期间形成了年龄≥18岁诊断为T2DM的患者队列。采用多变量Cox模型评估与HF发生相关的决定因素，并将其合并形成个体评分。结果：在167,618例患者中(52.3%为男性；平均年龄64.4岁（SD: 14.4）；HF发生率等于每1000人年6.7例)，我们开发了HFriskT2DM-HScore。当将其应用于验证子队列时，我们发现可解释的变异和鉴别值分别为43% （95% CI: 42-44）和81% （95% CI: 0.80-0.83）。校正斜率等于0.93 (95% CI: 0.81-1.1；p = 0.3123)。结论：HFriskT2DM-HScore可作为初级保健的决策支持系统，以适当简化NT-proBNP的处方和HF的早期识别。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.