THU248 Screening For Heart Failure In Patients With Diabetes Mellitus - A SwissDiab Study

Abstract

Abstract Disclosure: M. Brandle: None. L. Knaus: None. M. Quarella: None. M. Maeder: None. M. Buser: None. F. Renstrom: None. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have been shown to significantly reduce the risk of hospitalization for heart failure (HF) and death from cardiovascular causes in patients with diabetes and HF. Since the diagnosis of HF is challenging, the condition often remains undetected, and the prevalence in diabetes patients is unclear. The aim of this study was to evaluate the prevalence of HF in patients with diabetes enrolled in the Swiss Diabetes Registry (SwissDiab) and the proportion prescribed SGLT2i, to help to determine the need to reinforce clinical treatment guidelines and establish regular screening of HF.SwissDiab is a multicenter longitudinal observational study of outpatients with diabetes in tertiary care. The current study was conducted at the Cantonal Hospital of St.Gallen, Switzerland. All patients with a SwissDiab study visit between 28.09.2020 and 31.03.2022 were screened for HF according to a standardized protocol based on the diagnostic algorithm established by the European Society of Cardiology. Patients with ≥1 risk factor and/or symptoms of HF and a NT-proBNP ≥125 ng/L were referred to the Division of Cardiology for echocardiography and a clinical evaluation of HF, further stratified by HFpEF, HFmrEF, and HFrEF. The study was approved by the regional Ethics Committee East Switzerland (EKOS, PB_2016-01449) and all SwissDiab participants provided written informed consent. Out of 555 patients with diabetes, 530 had data available for analysis: 168 with type 1 diabetes (T1DM); 315 with type 2 diabetes (T2DM), and 47 with other forms of diabetes n=47. The median (IQR) age was 60.9 (49.0-69.0) years, n=162 (30.6%) were females, diabetes duration 14.0 (8.0-21.0) years, HbA1c 7.1 (6.6-7.8)%, low-density lipoprotein cholesterol 2.6 (2.1-3.2) mmol/L, and n=114 (21.5%) were current smokers. In total, HF was present in n=59 (11.1%) (T1DM, n=4 [2.4%]; T2DM, n=50 [15.9%]; other, n=5 [10.6%]) of which 35 (59.3%) were newly diagnosed. 34 of 59 patients presented with HFpEF (57.6%), 7 with HFmrEF (11.9%), and 18 with HFrEF (30.5%). Of the 59 patients with HF, n=19 (32.2%) were prescribed SGLT2i (HFpEF, n=7 [36.8%]; HFmrEF, n=2 [10.5%]; HFrEF, n=10 [52.6%]). Of the 24 patients with a previously known diagnosis of HF, 50% were treated with SGLT2i (2 out of 3 patients with HFmrEF and 10 out of 15 patients with HFrEF). All of the patients with HF that were treated with SGLT2i had T2D.The results indicate that roughly one in ten patients enrolled in SwissDiab have HF, and one in six patients with T2D. Patients with HFrEF (around 30% of cases) primarily have T2D, of which >50% were prescribed SGLT2i, as compared to 32% overall. Presentation: Thursday, June 15, 2023