New method may effectively predict heart failure in people with diabetes

In a new study, researchers have found a new way of accurately identifying which diabetes patients are most at risk for heart failure.

The research was conducted by a team from Brigham and Women’s Hospital and UT Southwestern Medical Center.

Heart failure is an important potential complication of type 2 diabetes that occurs frequently and can lead to death or disability.

A recent study has revealed that a new class of drugs known as SGLT2 inhibitors may be helpful for patients with heart failure.

These therapies may also be used in patients with diabetes to prevent heart failure from occurring in the first place.

In the new study, the team found a new, machine-learning derived model that can predict, with a high degree of accuracy, future heart failure among patients with diabetes.

To develop the risk score—called WATCH-DM—the team leveraged data from 8,756 patients with diabetes enrolled in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.

These data included a total of 147 variables, including demographics, clinical information, laboratory data and more.

The team used machine-learning methods capable of handling multidimensional data to determine the top-performing predictors of heart failure.

Over the course of almost five years, 319 patients developed heart failure. The team identified the 10 top-performing predictors of heart failure, which make up the WATCH-DM risk score: weight (BMI), age, hypertension, creatinine, HDL-C, diabetes control (fasting plasma glucose), QRS duration, myocardial infarction, and coronary artery bypass grafting.

Patients with the highest WATCH-DM scores faced a five-year risk of heart failure approaching 20%.

The team hopes that this risk score can be useful to clinicians on the ground—primary care physicians, endocrinologists, nephrologists, and cardiologists—who are caring for patients with diabetes and thinking about what strategies can be used to help them.

In addition to the tool’s usefulness for clinicians, the team also sees a key message from the study for patients with diabetes who are concerned about their risk of heart failure.

BMI was one of the top predictors of heart failure risk, which reinforces the idea that long-term excess weight may increase the future risk for heart failure.

They hope this work highlights ways to intervene—both through lifestyle changes and through the use of SGLT2 inhibitors—to delay or even entirely prevent heart failure.

One author of the study is Muthiah Vaduganathan, MD, MPH, a cardiologist at the Brigham.

The study is published in Diabetes Care.

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