Saudi Heart Association Position Statement on NT-proBNP for Cardiovascular Risk Screening in Asymptomatic Adults With Type 2 Diabetes Mellitus.

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease with a rapidly increasing prevalence, posing a significant public health challenge worldwide and in Saudi Arabia. Cardiovascular disease (CVD) is the leading cause of death among patients with T2DM, necessitating early detection and intervention to prevent disease progression. Elevated natriuretic peptide levels, particularly N-terminal pro-B-type natriuretic peptide (NT-proBNP), are promising biomarkers for CVD risk stratification in individuals with T2DM. However, the integration of these biomarkers in clinical management remains limited.

Methods: Published evidence and existing guidelines/consensuses related to the use of NT-proBNP for CVD risk stratification in T2DM patients were reviewed and discussed by a multidisciplinary expert panel from Saudi Arabia. The panel also considered the unique characteristics of the local Saudi population, healthcare system, resources, and medical expertise.

Results and conclusions: NT-proBNP-based screening holds significant promise for improving CVD outcomes in T2DM patients by identifying at-risk individuals and guiding management approaches. Based on available evidence, the Saudi Heart Association (SHA) developed an evidence-based position statement on the use of NT-proBNP for CVD risk stratification in patients with T2DM who have no established CVD (asymptomatic). The proposed algorithm for NT-proBNP-based screening aims to improve the early identification of at-risk patients with T2DM, inform clinical management decisions, and enhance patient outcomes in Saudi Arabia. The algorithm includes age-adapted thresholds to reduce unnecessary referrals and medical testing. The SHA recognizes the need for further research and local data collection on NT-proBNP-based screening, in addition to clinician training to address the limitations and improve the practical implementation of NT-proBNP screening in routine clinical practice.