Screening and Treatment Using a Risk-Based Approach with NT-proBNP Guidance in Diabetes Mellitus: The STRONG-DM Pilot Study
Main finding · Initiation of any CKM therapyResult — go to the resultIncidence rate ratio 3.03 95% CI 2.18–4.31Authors' 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
Methodological detailsretrospectively identified controls
- Retrospectively identified controls
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
| Outcome | IRR (95% CI) | P value | |
|---|---|---|---|
| Any CKM therapy, by HF risk (subgroup) · high-risk | 5.03 (3.06–8.77) | ||
| Any CKM therapy, by HF risk (subgroup) · low-risk | 1.82 (1.15–2.96) | ||
| 0.10.31310Incidence rate ratio (log scale) |
- 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: The STRONG-DM Pilot Study. JACC Heart Fail. Published 1 June 2026. doi:10.
Summarised from the published abstract; every number is checked against it