{"id":139805,"date":"2026-04-01T16:44:31","date_gmt":"2026-04-01T20:44:31","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=139805"},"modified":"2026-04-01T16:44:32","modified_gmt":"2026-04-01T20:44:32","slug":"nt-probnp-based-screening-identifies-undiagnosed-heart-failure-in-patients-with-diabetes-the-tartan-hf-trial","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=139805","title":{"rendered":"NT-proBNP-Based Screening Identifies Undiagnosed Heart Failure in Patients with Diabetes: The TARTAN-HF Trial"},"content":{"rendered":"\n<p>Key Points<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In the TARTAN-HF Trial, NT-proBNP\u2013guided screening followed by echocardiography identified a new HF diagnosis in 25% of screened patients compared with just 1% under usual care, with a number needed to screen of only 5.<\/li>\n\n\n\n<li>Majority of newly diagnosed HF was HFpEF (23%), with HFrEF and HFmrEF each accounting for less than 1%.<\/li>\n\n\n\n<li>Screening was associated with significantly higher rates of guideline-directed therapy initiation, including a near-doubling of SGLT2 inhibitor use, and a significantly lower rate of HF hospitalization or all-cause death in the screening arm.<\/li>\n<\/ul>\n\n\n\n<p>Heart failure affects patients with diabetes at disproportionately high rates, yet it frequently goes unrecognized until clinical decompensation occurs. Early diagnosis is critical because effective disease-modifying therapies; including SGLT2 inhibitors, which carry dedicated guideline recommendations across all HF phenotypes, can only be optimally deployed once the diagnosis is established. Despite this, natriuretic peptide measurement for HF screening in diabetes is rarely performed in routine care, and until now, no randomized trial had evaluated efficacy of a systematic screening strategy. The TARTAN-HF trial (<a href=\"https:\/\/clinicaltrials.gov\/study\/NCT05705869?term=TARTAN%20HF&amp;rank=1#collaborators-and-investigators\">NCT05705869<\/a>), presented as a Featured Clinical Research at ACC.26, was designed to address this gap directly.<\/p>\n\n\n\n<p>TARTAN-HF was a prospective, multicenter, open-label randomized controlled trial enrolling adults aged 40 or older with type 1 or type 2 diabetes and at least one additional HF risk factor; including chronic kidney disease, coronary artery disease, ischemic stroke, loop diuretic use, COPD, peripheral artery disease, or atrial fibrillation. These patients had no prior HF diagnosis. Participants were recruited through the NHS Research Scotland Diabetes Register and diabetes outpatient clinics across Scotland. Between December 2022 and May 2025, 706 patients were randomized 1:1 to a natriuretic peptide\u2013based screening strategy (n=354) or usual care (n=352). In the screening arm, NT-proBNP was measured and patients with levels \u2265125 pg\/mL underwent clinical review and echocardiography. The primary outcome was a new HF diagnosis at 6 months, defined per 2021 ESC criteria as the presence of signs and\/or symptoms of HF, NT-proBNP \u2265125 pg\/mL, and echocardiographic evidence of structural remodeling or elevated filling pressures.<\/p>\n\n\n\n<p>At baseline, the cohort was elderly (mean age 70 years), predominantly male (69%), and largely affected by type 2 diabetes (90%), with a median diabetes duration of 12 years. The most common qualifying HF risk factor was chronic kidney disease (57%), followed by coronary artery disease (39%). In the screening arm, 49% had NT-proBNP \u2265125 pg\/mL and proceeded to echocardiography.<\/p>\n\n\n\n<p>The primary outcome was striking. HF was diagnosed in 87 of 354 patients (25%) in the screening arm versus 2 of 352 (1%) in the usual care arm (OR 58; 95% CI, 14\u2013236; p&lt;0.001). All 87 diagnoses were made through the screening process itself, with no additional cases emerging during the 6-month follow-up period. HFpEF accounted for 93% of all newly diagnosed HF (n=81, 23% of the screening arm), with HFmrEF and HFrEF each identified in just 3 patients (0.8% each). Among those diagnosed with HF, KCCQ-12 summary scores were meaningfully lower than in those without HF (median 66 vs. 90), and 84% reported exertional dyspnea, 53% fatigue, and 53% peripheral edema; symptoms that had not prompted a formal diagnosis under standard care.<\/p>\n\n\n\n<p>Screening also translated into meaningful therapeutic action. SGLT2 inhibitor use increased from 21% at baseline to 72% at 6 months among those diagnosed with HFmrEF or HFpEF through screening. In the exploratory composite of HF hospitalization or all-cause death, the screening arm demonstrated a 55% relative risk reduction compared with usual care (HR 0.45; 95% CI, 0.22\u20130.91; p=0.026), driven primarily by a significant reduction in all-cause mortality (9.4 vs. 34.3 per 1000 patient-years; HR 0.27; 95% CI, 0.10\u20130.74; p=0.010).<\/p>\n\n\n\n<p>These findings from TARTAN-HF establish that a targeted NT-proBNP\u2013based screening strategy in high-risk patients with diabetes is highly effective at uncovering undiagnosed HF, especially HFpEF, enabling timely initiation of guideline-directed therapy and with signals of meaningful clinical benefit. The number needed to screen of just 5 makes this among the most efficient screening strategies reported in cardiovascular medicine.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Key Points Heart failure affects patients with diabetes at disproportionately high rates, yet it frequently goes unrecognized until clinical decompensation occurs. Early diagnosis is critical because effective disease-modifying therapies; including SGLT2 inhibitors, which carry dedicated guideline recommendations across all HF phenotypes, can only be optimally deployed once the diagnosis is established. Despite this, natriuretic peptide [&hellip;]<\/p>\n","protected":false},"author":40604,"featured_media":139806,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"aside","meta":{"footnotes":""},"categories":[1074,8],"tags":[1075,45,47,185],"ppma_author":[1031],"class_list":{"0":"post-139805","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-acc-2026","8":"category-news","9":"tag-acc-2026","10":"tag-conference","11":"tag-featured","12":"tag-news","13":"post_format-post-format-aside","14":"author-basir-gill"},"authors":[{"term_id":1031,"user_id":40604,"is_guest":0,"slug":"basir-gill","display_name":"Basir Gill MD","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/05064ea2c277f8906826ab0662151459a584dc4b50046758e59dbf39135256c6?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/139805","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40604"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=139805"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/139805\/revisions"}],"predecessor-version":[{"id":139807,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/139805\/revisions\/139807"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/139806"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=139805"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=139805"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=139805"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=139805"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}