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Review article: Medical guidelines

Vol. 154 No. 10 (2024)

Recommendations for early identification of heart failure in patients with diabetes: Consensus statement of the Swiss Society of Endocrinology and Diabetology and the Heart Failure Working Group of the Swiss Society of Cardiology

DOI
https://doi.org/10.57187/s.4000
Cite this as:
Swiss Med Wkly. 2024;154:4000
Published
09.10.2024

Summary

Diabetes is a well-recognised risk factor for the development of heart failure, with a prevalence higher than 30% in patients with diabetes aged over 60 years. Heart failure often emerges as the primary cardiovascular manifestation in patients with type 2 diabetes and appears to be even more prevalent in type 1 diabetes. In Switzerland, there are approximately 500,000 individuals with diabetes, and the number of affected people has been steadily rising in recent years. Therefore, the consequences of heart failure will affect an increasing number of patients, further straining the Swiss healthcare system. Early lifestyle modification and initiation of appropriate treatment can prevent or at least significantly delay the onset of symptomatic heart failure by several years. These facts underscore the urgent need for early detection of individuals with subclinical heart failure, which often remains undiagnosed until the first episode of acute heart failure requiring hospital admission occurs. To address this issue, the European Society of Cardiology, the American Diabetes Association (ADA) and other international professional societies have published recommendations on heart failure screening, diagnosis and management. To address this issue in Switzerland, experts from the Swiss Society of Endocrinology and Diabetology, the Swiss Society of Cardiology and the General Internal Medicine specialty met and prepared a consensus report including a simple diagnostic algorithm for use in everyday practice.

References

  1. Bozkurt B, Coats AJ, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail. 2021 Mar;23(3):352–80. doi: https://doi.org/10.1002/ejhf.2115 DOI: https://doi.org/10.1002/ejhf.2115
  2. Groenewegen A, Rutten FH, Mosterd A, Hoes AW. Epidemiology of heart failure. Eur J Heart Fail. 2020 Aug;22(8):1342–56. doi: https://doi.org/10.1002/ejhf.1858 DOI: https://doi.org/10.1002/ejhf.1858
  3. Ceriello A, Catrinoiu D, Chandramouli C, Cosentino F, Dombrowsky AC, Itzhak B, et al.; D&CVD EASD Study Group. Heart failure in type 2 diabetes: current perspectives on screening, diagnosis and management. Cardiovasc Diabetol. 2021 Nov;20(1):218. doi: https://doi.org/10.1186/s12933-021-01408-1 DOI: https://doi.org/10.1186/s12933-021-01408-1
  4. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al.; Authors/Task Force Members; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2022 Jan;24(1):4–131. doi: https://doi.org/10.1002/ejhf.2333 DOI: https://doi.org/10.1002/ejhf.2333
  5. Bayes-Genis A, Docherty KF, Petrie MC, Januzzi JL, Mueller C, Anderson L, et al. Practical algorithms for early diagnosis of heart failure and heart stress using NT-proBNP: A clinical consensus statement from the Heart Failure Association of the ESC. Eur J Heart Fail. 2023 Nov;25(11):1891–8. doi: https://doi.org/10.1002/ejhf.3036 DOI: https://doi.org/10.1002/ejhf.3036
  6. Seferović PM, Vardas P, Jankowska EA, Maggioni AP, Timmis A, Milinković I, et al.; National Heart Failure Societies of the ESC member countries (see Appendix). The Heart Failure Association Atlas: Heart Failure Epidemiology and Management Statistics 2019. Eur J Heart Fail. 2021 Jun;23(6):906–14. doi: https://doi.org/10.1002/ejhf.2143 DOI: https://doi.org/10.1002/ejhf.2143
  7. Boonman-de Winter LJ, Rutten FH, Cramer MJ, Landman MJ, Liem AH, Rutten GE, et al. High prevalence of previously unknown heart failure and left ventricular dysfunction in patients with type 2 diabetes. Diabetologia. 2012 Aug;55(8):2154–62. doi: https://doi.org/10.1007/s00125-012-2579-0 DOI: https://doi.org/10.1007/s00125-012-2579-0
  8. Pop-Busui R, Januzzi JL, Bruemmer D, Butalia S, Green JB, Horton WB, et al. Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association. Diabetes Care. 2022 Jul;45(7):1670–90. doi: https://doi.org/10.2337/dci22-0014 DOI: https://doi.org/10.2337/dci22-0014
  9. Birkeland KI, Bodegard J, Eriksson JW, Norhammar A, Haller H, Linssen GC, et al. Heart failure and chronic kidney disease manifestation and mortality risk associations in type 2 diabetes: A large multinational cohort study. Diabetes Obes Metab. 2020 Sep;22(9):1607–18. doi: https://doi.org/10.1111/dom.14074 DOI: https://doi.org/10.1111/dom.14074
  10. Schweizerische Diabetesgesellschaft. Über Diabetes - Schweizerische Diabetesgesellschaft. Available from: https://www.diabetesschweiz.ch/ueber-diabetes.html
  11. Gregory GA, Robinson TI, Linklater SE, Wang F, Colagiuri S, de Beaufort C, et al.; International Diabetes Federation Diabetes Atlas Type 1 Diabetes in Adults Special Interest Group. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study [Erratum in: Lancet Diabetes Endocrinol. 2022 Nov; 10] [11] [:e11]. Lancet Diabetes Endocrinol. 2022 Oct;10(10):741–60. doi: https://doi.org/10.1016/S2213-8587(22)00218-2 DOI: https://doi.org/10.1016/S2213-8587(22)00280-7
  12. Knaus L, Quarella M, Buser M, Maeder MT, Renström F, Brändle M. Screening for heart failure in patients with diabetes mellitus in tertiary care - A SwissDiab study. Diabetes Res Clin Pract. 2024 Mar;209:111565. doi: https://doi.org/10.1016/j.diabres.2024.111565 DOI: https://doi.org/10.1016/j.diabres.2024.111565
  13. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [Erratum in: Circulation. 2022 May 3;145] [18] [:e1033. Erratum in: Circulation. 2022 Sep 27;146] [13] [:e185. Erratum in: Circulation. 2023 Apr 4;147] [14] [:e674]. Circulation. 2022 May;145(18):e895–1032. doi: https://doi.org/10.1161/CIR.0000000000001063 DOI: https://doi.org/10.1161/CIR.0000000000001063
  14. Huelsmann M, Neuhold S, Resl M, Strunk G, Brath H, Francesconi C, et al. PONTIAC (NT-proBNP selected prevention of cardiac events in a population of diabetic patients without a history of cardiac disease): a prospective randomized controlled trial. J Am Coll Cardiol. 2013 Oct;62(15):1365–72. doi: https://doi.org/10.1016/j.jacc.2013.05.069 DOI: https://doi.org/10.1016/j.jacc.2013.05.069
  15. Schütt K, Aberle J, Bauersachs J, Birkenfeld A, Frantz S, Ganz M, et al. Positionspapier Herzinsuffizienz und Diabetes. Kardiologie. 2022;16(5):358–71. doi: https://doi.org/10.1007/s12181-022-00562-4 DOI: https://doi.org/10.1007/s12181-022-00562-4
  16. Kaser S, Hülsmann M, Siostrzonek P, Clodi M. Mörtl. D, Sourij H. Positionspapier der ÖDG und ÖKG Diabetes mellitus und Herzinsuffizienz. Chronic heart failure and diabetes. A position paper. J. Kardol. 2021;28(1-2):14–20.
  17. Ledwidge M, Gallagher J, Conlon C, Tallon E, O’Connell E, Dawkins I, et al. Natriuretic peptide-based screening and collaborative care for heart failure: the STOP-HF randomized trial. JAMA. 2013 Jul;310(1):66–74. doi: https://doi.org/10.1001/jama.2013.7588 DOI: https://doi.org/10.1001/jama.2013.7588
  18. Walter E, Arrigo M, Allerstorfer S, Marty P, Hülsmann M. Cost-effectiveness of NT-proBNP-supported screening of chronic heart failure in patients with or without type 2 diabetes in Austria and Switzerland. J Med Econ. 2023;26(1):1287–300. doi: https://doi.org/10.1080/13696998.2023.2264722 DOI: https://doi.org/10.1080/13696998.2023.2264722
  19. Gallagher J, Watson C, Campbell P, Ledwidge M, McDonald K. Natriuretic Peptide-based Screening and Prevention of Heart Failure. Card Fail Rev. 2017 Nov;3(2):83–5. doi: https://doi.org/10.15420/cfr.2017:20:1 DOI: https://doi.org/10.15420/cfr.2017:20:1
  20. Marx N, Federici M, Schütt K, Müller-Wieland D, Ajjan RA, Antunes MJ, et al.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023 Oct;44(39):4043–140. doi: https://doi.org/10.1093/eurheartj/ehad192 DOI: https://doi.org/10.1093/eurheartj/ehad192
  21. Gastaldi G, Lucchini B, Thalmann S, Alder S, Laimer M, Brändle M, et al.; Working group of the SGED/SSED. Swiss recommendations of the Society for Endocrinology and Diabetes (SGED/SSED) for the treatment of type 2 diabetes mellitus (2023). Swiss Med Wkly. 2023 Apr;153(4):40060. doi: https://doi.org/10.57187/smw.2023.40060 DOI: https://doi.org/10.57187/smw.2023.40060
  22. Deutsche Diabetes Gesellschaft. S3-Leitlinie Therapie des Typ-1-Diabetes. Available from: https://register.awmf.org/assets/guidelines/057-013l_S3-Therapie-Typ-1-Diabetes_2023-09_1.pdf
  23. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al.; ESC Scientific Document Group. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure [Erratum in: Eur Heart J. 2024 Jan 1;45] [1]. Eur Heart J. 2023 Oct;44(37):3627–39. doi: https://doi.org/10.1093/eurheartj/ehad195 DOI: https://doi.org/10.1093/eurheartj/ehad195
  24. Klein L, Gheorghiade M. Coronary artery disease and prevention of heart failure. Med Clin North Am. 2004 Sep;88(5):1209–35. doi: https://doi.org/10.1016/j.mcna.2004.03.002 DOI: https://doi.org/10.1016/j.mcna.2004.03.002
  25. Christ E, Brändle M, Czock A, Diem P, Fischer-Taeschler D, Gastaldi G, et al. HagonTraub I, Margrit Hasler M, Zanella I; Arbeitsgruppe Disease Management Diabetes (DMD) der Schweizerischen Gesellschaft für Endokrinologie und Diabetologie (SGED/SSED). Kriterien für ein «gutes» Disease Management Diabetes in der Grundversorgung. Überarbeitete Version Juni 2017, verabschiedet 23. August 2017. Available from: https://www.sgedssed.ch/fileadmin/user_upload/6_Diabetologie/64_Ressourcen_Hausarzt/Diabetes_Kriterien_2017_SGED_def.pdf