Targeted Assessment in High-Risk Patients With Diabetes to Identify Undiagnosed Heart Failure (TARTAN-HF).
Daniel Taylor-Sweet, Mark C Petrie, Gemma McKinley et al.
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In 30 seconds
TARTAN-HF was a prospective, multicenter, unblinded randomized controlled trial of community-based adults aged ≥40 years with type 1 or type 2 diabetes, at least one additional heart failure (HF) risk factor, and no known HF. Participants received natriuretic peptide screening with echocardiography when N-terminal pro-B-type natriuretic peptide was ≥125 pg/mL, or usual care. At 6 months, HF was diagnosed in 87 (24.6%) in the screening group vs 2 (1%) in usual care (OR: 58; 95% CI: 14-236; P < 0.001); most identified cases had preserved ejection fraction.
Key findings
- At 6 months, HF was diagnosed in 87 (24.6%) in the screening group vs 2 (1%) in usual care (OR: 58; 95% CI: 14-236; P < 0.001).
- The number needed to screen was 5 (95% CI: 4-6).
- Most identified HF cases were HF with preserved ejection fraction (23%).
- Sodium-glucose cotransporter 2 inhibitor use in the screening group increased from 24% to 39%.
Why it matters
The trial shows that targeted natriuretic peptide screening can uncover symptomatic HF that is not otherwise diagnosed in people with diabetes and additional HF risk factors. Identified patients had poorer health status, underscoring the potential clinical importance of detection. The findings add randomized evidence to a setting where guidelines are inconsistent, while further evaluation is needed before screening strategies are adopted broadly.
What to keep in mind
The trial was unblinded and conducted in community-based participants recruited in the west of Scotland; the primary outcome was assessed at 6 months.