NT-proBNP Screening Detects Unrecognized Heart Failure in Patients With Diabetes: Study

A new study published in the Journal of the American College of Cardiology found that N-terminal pro-B-type natriuretic peptide (NT-proBNP)-based screening identified a significantly greater proportion of patients with previously unrecognized symptomatic heart failure, suggesting that systematic biomarker screening could help detect HF earlier in people with diabetes and facilitate timely evaluation and treatment.

Heart failure is one of the most common cardiovascular complications associated with diabetes, yet it often remains undetected until symptoms become severe. While international diabetes and heart failure guidelines differ on whether routine screening should be recommended, the new trial provides strong evidence supporting a targeted screening approach.

This trial enrolled 706 community-based adults aged 40 years or older from western Scotland between January 2023 and May 2025. Participants had either type 1 or type 2 diabetes, at least one additional heart failure risk factor, and no previous diagnosis of heart failure. They were randomly assigned to either a screening group, which underwent NT-proBNP testing followed by echocardiography if levels were elevated, or to a usual-care group.

Heart failure was identified in 87 participants (24.6%) in the screening group when compared to just two participants (1%) receiving usual care. The findings translated to an odds ratio of 58, which highlighted the substantial effectiveness of the screening strategy. This study estimated that screening only 5 individuals would identify one previously unrecognized case of heart failure.

Most newly diagnosed patients had heart failure with preserved ejection fraction (HFpEF). Research also found that individuals with previously unrecognized heart failure reported significantly poorer health status than those without the condition, which emphasized the clinical importance of earlier detection.

The screening strategy also influenced treatment decisions. Use of sodium-glucose cotransporter 2 (SGLT2) inhibitors increased from 24% to 39% among participants in the screening group following diagnosis. This suggests that identifying hidden heart failure can facilitate the initiation of disease-modifying therapies with proven cardiovascular benefits. Overall, the findings suggest that targeted heart failure screening can identify a substantial proportion of symptomatic but undiagnosed cases, particularly HFpEF, among people with diabetes. 

Source:

Taylor-Sweet, D., Petrie, M. C., McKinley, G., McGlynn, L., Jarvie, J., Beazer, J., Butler, E., MacDonald, E., Welsh, P., Martinson, M., Brooksbank, K., Barnett, A., Kerr, J., Petrie, C. J., Weir, R. A. P., Gold, S. T., Hall, L., Kennon, B., Llano, A., … Docherty, K. F. (2026). Targeted Assessment in high-Risk paTients with diabetes to ideNtify undiagnosed Heart Failure (TARTAN-HF). Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2026.06.042