Abstract
Introduction: Type 2 diabetes is an important co-morbid condition strongly associated with the risk of developing heart failure (HF). Risk scores such as the WATCH-DM score that predict the occurrence of HF among diabetes patients are largely based on data collected from white ethnicities. Hypothesis Here, we sought to investigate surrogate markers for predicting HF among type 2 diabetes patients of Asian ethnicities Methods Data on baseline characteristics (according to WATCH-DM scoring), laboratory information (mainly sugar profiles, renal function, and Natriuretic Peptide [NP]: N-Terminal Pro-B-Type Natriuretic Peptide [NT-proBNP], and 12-lead surface electrocardiography (ECG) findings were collected among adult Asians (aged ≥ 20 years old) with type 2 diabetes free from HF diagnosis from a multi-center cohort. We analyzed the clinical indicators for incident HF during the entire course of follow-up. Results: Among 6,668 study participants (mean age: 62.9±14.3 years, 49.3% male), the overall HF incidence was 13.7% (n=916) during a median of 3.6 years ([25 th ~75 th ]: 1.86~5.57 years) of follow-up period. Using backward multivariate selection, we identified aging (adjusted odd ratio [aOR]: 1.21, per 10-year increment), higher body mass index (aOR: 1.11, per 5 kg/m 2 increment), history of myocardial infarction (aOR: 2.26), atrial fibrillation rhythm (aOR: 1.72), prolonged QRS duration (aOR: 1.08, per 10-ms increment) by ECG (according to WATCH-DM score), higher NT-proBNP level (aOR: 1.47, per 1 log-transformed unit increment), and renal impairment (aOR: 1.06, eGFR per 10 mL/min/1.73m 2 decline) as independent predictors of incident HF. The optimal cutoff of NT-proBNP in predicting HF incidence was 77.3 pg/mL. Conclusions: In this large-scale survey, our findings highlighted the baseline clinical indicators and the potential utilization of ECG and NP in HF prediction among diabetic Asians. Additionally, we demonstrated that optimal predictive value of NP to be remarkably lower than contemporary HF cutoff independent of WATCH-DM score.
Published Version
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