1231-P: Influence of Diabetes on the Progression of Preclinical Stage B Heart Failure Phenotypes to Heart Failure

Abstract

Introduction: The extent to which diabetes influences progression from preclinical heart failure (HF) stage B phenotypes (2021 Universal Definition) to overt HF or death is unknown. Methods: We included 4,264 adults with preclinical HF (stage A [n = 1,174] or B [n = 3,090]) who attended the Atherosclerosis Risk in Communities (ARIC) Study Visit 5 (2011-2013). Stage A was defined by HF risk factors only. Stage B1: echocardiographic abnormalities but no biomarker elevation; Stage B2: elevated NT-pro-BNP ≥125 pg/mL and/or hscTnT>14 ng/L but no echocardiographic abnormality; Stage B3: echocardiographic and biomarker abnormalities. We assessed the associations of diabetes and each preclinical stage B phenotype with incident HF and HF or death. Results: Among the participants (mean age 76 years, 62% women, 24% Black), there were 383 HF events and 730 deaths during 8.6 years of follow-up. Diabetes conferred a high absolute risk of HF across all preclinical stages B HF, but more so for the Stage B3 phenotype (Table). In cross-categories of preclinical HF stages (A and B) and diabetes status, participants with diabetes and Stage B3 had the highest risks of HF or HF and death combined, compared to those in stage A without diabetes. Conclusion: Addressing diabetes appears to be critical in stage B individuals with both echocardiographic and biomarkers abnormalities for preventing the progression to HF. Disclosure J.Echouffo tcheugui: None. C.E.Ndumele: None. S.Zhang: None. K.Matsushita: Consultant; Fukuda Denshi, Akebia Therapeutics, Inc., AMGA, Other Relationship; Kowa Company, Ltd. V.Nambi: Research Support; Amgen Inc., Kowa Pharmaceuticals America, Inc. H.Skali: Consultant; Astellas Pharma Inc., Elsevier, Wolters Kluwer Health, APM Tunisia / Hikma. E.Selvin: None. Funding National Institutes of Health (K23HL153774)