The battle against heart failure (HF) in individuals with diabetes, particularly those showing no signs of atherosclerotic cardiovascular disease (ASCVD), is taking a promising turn. Researchers from the University of Texas have pioneered a novel two-step screening process designed to accurately identify those at heightened risk for heart failure, thereby enabling earlier and more effective use of preventative treatments.

      This innovative approach was tested on adults with diabetes but without initial heart failure, utilizing data from seven community-based cohorts. By employing a combination of traditional risk scores, such as the WATCH-DM score, and cutting-edge biomarkers, the team's method goes beyond conventional screening. This dual-layered strategy is adept at identifying individuals who may not be flagged as high-risk through standard screening processes, advocating for a more nuanced application of preventative drugs like sodium-glucose cotransporter 2 inhibitors (SGLT2i), known for their efficacy in mitigating heart failure risk.

      The remarkable findings from the study are encouraging over a five-year period, 6.2% of participants without ASCVD developed heart failure. This underlines the effectiveness of the two-step screening in catching a broader spectrum of individuals at risk, often requiring surprisingly few treatments to prevent one HF event. Notably, while one-step screening methods have their merits, they overlooked a significant fraction of participants who later experienced heart failure, underscoring the comprehensive potential of the two-step approach.

      This research lays down a practical pathway for preemptive action against heart failure within people with diabetes. With selective NT-proBNP testing following the WATCH-DM score proving to effectively pinpoint those who could significantly benefit from SGLT2i, the question arises: Are we witnessing the dawn of a new era in heart failure prevention for people with diabetes?

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