ArticleCardiovascular diabetology2024
Sex differences in the diagnostic algorithm of screening for heart failure by symptoms and NT-proBNP in patients with type 2 diabetes.
Article in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- [Sex and gender-specific aspects in prediabetes and diabetes mellitus - Clinical recommendations (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Benefits of sacubitril/valsartan alone and in combination with dapagliflozin in a preclinical female model of cardiometabolic and age-related cardiac dysfunction.Cardiovascular diabetology · 2026Article
- The Epidemiological and Clinical Profiling of Heart Failure-A Retrospective and Comparative Analysis of Cases Before, During, and After the COVID-19 Pandemic in a Romanian Emergency County Clinical Hospital.Medicina (Kaunas, Lithuania) · 2025Observational
- Barriers and solutions in women's health research and clinical care: a call to action.Lancet regional health. Americas · 2025Review
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Authors and funding
8 authors.
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Abstract
objectivesThis study aimed to assess the guideline recommended diagnostic tools NT-proBNP and NYHA classification, with a focus on sex-specific differences.
backgroundPatients with Type 2 Diabetes (T2D) face a heart failure (HF) risk up to four times higher than those without T2D, particularly affecting women more than twice as much as men. Despite distinct pathophysiological differences between men and women, there are currently no sex-specific recommendations for the diagnostic algorithm of HF in diabetic patients.
methodsA total of 2083 patients with T2D were enrolled, and the primary endpoint was heart failure during hospitalization within a 5-year timeframe. The secondary endpoint was all-cause death.
resultsIn female patients, frequency of HF diagnosis prior to or during hospitalization and mortality did not differ significantly between NYHA II and III, in contrast to male patients. Additionally, there was no notable difference in mean NT-proBNP levels between NYHA stage II and III only in female patients. The multivariable regression analysis highlighted NYHA classification not to be a predictor of NT-proBNP levels in female but solely in male patients. On multivariable Cox regression NYHA score was also no significant risk factor for occurence of HF in female patients. Furthermore, there was no significant disparity in mortality between men with NT-proBNP levels between 125 and 400 pg/ml and those below 125 pg/ml, whereas in women mortality was significantly higher in the group with NT-proBNP levels between 125 and 400 pg/ml than below 125 pg/ml.
conclusionThese findings suggest that NYHA classification may not be the most suitable tool for assessing the diagnosis of HF in female patients with T2D. Moreover, the need for consideration of a more symptom-independent screening for HF in female patients with T2D and re-evaluation of current guidelines especially regarding sex-specific aspects is highlighted.
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