TARTAN-HF Trial Reveals One in Four Diabetics Has Undiagnosed Heart Failure
Key Insights
The TARTAN-HF trial found that 24.9% of diabetes (search) patients with heart failure (search) risk factors had previously undetected heart failure, compared to just 1% in the control group.
The study tested a simple GP-led screening pathway using NT-proBNP (search) blood testing followed by cardiac ultrasound to identify undiagnosed heart failure (search) in diabetic patients.
The screening approach enabled earlier identification of heart failure (search) and initiation of guideline-directed therapy that could slow disease progression and improve patient outcomes.
A major UK-led study has revealed that nearly one in four diabetes (search) patients with heart failure (search) risk factors are living with undiagnosed heart failure, highlighting a significant gap in cardiovascular care for this vulnerable population. The TARTAN-HF trial, conducted by the University of Glasgow with funding from AstraZeneca, Roche Diagnostics (search), and echocardiography software firm Us2.ai (search), found that 24.9% of patients with diabetes and one or more risk factors for heart failure received a diagnosis within six months, compared to just 1% of a control group.
Simple Screening Pathway Shows Promise
The study tested a straightforward, community-based care pathway designed to work within existing NHS procedures. The approach involves an initial GP consultation to assess symptoms, followed by an NT-proBNP (search) biomarker blood test to screen for potential heart failure (search), and fast-track access to cardiac ultrasound testing.
This GP-led pathway was compared to routine clinical care for diabetes (search) in the NHS across 700 subjects recruited at two NHS hospitals in Glasgow. The results, presented at the American College of Cardiology congress, demonstrated the pathway's effectiveness in identifying previously unrecognized heart failure (search) cases.
Clinical Impact and Implementation
According to the investigators, the screening pathway enabled earlier identification of heart failure (search) and facilitated earlier initiation of guideline-directed therapy that could slow disease progression, extend life, alleviate symptoms, and improve patients' quality of life.
"The results of TARTAN-HF highlight that a substantial number of people living with diabetes (search) are living with unrecognised heart failure (search)," said TARTAN-HF investigator Mark Petrie, professor of cardiology at the University of Glasgow. "These people have a significant burden of limiting symptoms and impaired quality of life. The screening process tested in TARTAN-HF is easy to implement in clinical practice and could significantly benefit people living with diabetes."
Dr Kieran Docherty, Clinical Senior Lecturer at the University of Glasgow's School of Cardiovascular & Metabolic Health, emphasized the practical implications: "We know that many of the symptoms and signs of heart failure (search) are non-specific and may go unrecognised as potentially being due to heart failure for a long time. The strategy used in our trial is simple and easy-to-implement in clinical practice and will aid in the early identification of heart failure in people with diabetes (search) and facilitate the initiation of medications that we know improve outcomes in patients with heart failure."
Healthcare System Integration
The pathway has been specifically designed to integrate with established NHS procedures, targeting diagnostic resources where they are most needed and offering a scalable approach for primary care teams and specialists in cardiology, nephrology, and diabetology.
Dr Edward Piper, medical director at AstraZeneca UK, noted the broader healthcare implications: "Delayed diagnosis and treatment of heart failure (search) in people with type 2 diabetes (search) contributes to poor long-term outcomes. TARTAN-HF demonstrates that targeted, risk-based screening can identify previously undiagnosed heart failure in approximately one in four high-risk patients with diabetes (search) enabling earlier intervention with guideline-directed therapy."
Future Research and Cost Analysis
The researchers are currently conducting additional analyses to determine how earlier detection of undiagnosed heart failure (search) could impact the costs of providing NHS care for at-risk diabetes (search) patients. Professor Petrie suggested that the screening approach could be expanded: "Further screening strategies could help identify other undiagnosed cardiovascular conditions, including atrial fibrillation (search) and aortic stenosis (search). Going forward, larger trials in other regions and countries would be beneficial to more widely demonstrate the performance of heart failure screening in these patients."
Dr Christian Simon, Head of Global Medical Affairs at Roche Diagnostics (search), highlighted the diagnostic component's significance: "We are proud to have supported the landmark TARTAN-HF trial. These findings demonstrate the transformative power of early, accessible diagnostics like the NT-proBNP (search) blood test."
The company noted that the findings support the objectives of the NHS England 10-Year Plan and NHS Scotland's Heart Disease Action Plan to identify and treat cardiovascular disease (search) early and in the community.