Cardiometabolic & kidneyCohort study

Screening and Treatment Using a Risk-Based Approach with NT-proBNP Guidance in Diabetes Mellitus

JACC Heart FailPublished

  • Prospective intervention study with matched control cohort
  • retrospectively identified controls

Authors' conclusion

Among adults with T2DM and high risk for developing HF, a virtual CKM prevention strategy was feasible and increased prescription rates of preventive therapies.

Study context

Population
Adults with T2DM and no history of heart failure (HF) seen in primary care62.4% women
Participants
545 adults
Exposure
Virtual cardio-kidney-metabolic (CKM) prevention strategy vs matched control
Outcome
Prescription rate of CKM therapies (SGLT2 inhibitors, GLP-1 receptor agonists or finerenone)
Follow-up
6-month follow-up

Main finding

Initiation of any CKM therapy · 180-day median follow-up

Incidence rate ratio

3.03

95% CI 2.18–4.31

P < 0.001

By group

Intervention vs Matched control
IRR 3.03 (95% CI 2.18–4.31); P < 0.001

As reported in the abstract

Observational data: associations, not effects.

Further findings

New SGLT2 inhibitor prescriptions · 180-day median follow-up

P < 0.001

New finerenone prescriptions · 180-day median follow-up

P < 0.001

OutcomeIRR (95% CI)P value
Any CKM therapy, by HF risk (subgroup) · high-risk5.03 (3.06–8.77)
Any CKM therapy, by HF risk (subgroup) · low-risk1.82 (1.15–2.96)
  • Any CKM therapy, by HF risk (subgroup): P interaction = 0.005

GLP-1 receptor agonist initiation

No significant difference

Feasibility: NT-proBNP screening and risk identification (intervention)

NT-proBNP screening ordered
93.4%
Identified as high risk for HF
36.9%
Additional high-risk patients identified by NT-proBNP (low risk by WATCH-DM)
16.7%

Original publication

Screening and Treatment Using a Risk-Based Approach with NT-proBNP Guidance in Diabetes Mellitus. JACC Heart Fail. Published 1 June 2026. doi:10.1016/j.jchf.2026.103153

Summarised from the published abstract; every number is checked against it