Cardiac Biomarkers, Intensive Lifestyle Intervention, and Heart Failure Subtypes in Diabetes: Look AHEAD Cardiac Biomarker Ancillary Study (Heart Failure March 2026)-Article: Cardiac Biomarkers, Intensive Lifestyle Intervention, and Heart Failure Subtypes in Diabetes: Look AHEAD Cardiac Biomarker Ancillary Study

Article: Cardiac Biomarkers, Intensive Lifestyle Intervention, and Heart Failure Subtypes in Diabetes: Look AHEAD Cardiac Biomarker Ancillary Study

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This Look AHEAD ancillary study examined whether NT-proBNP, a cardiac stress biomarker, predicts risk of heart failure subtypes in adults with type 2 diabetes and overweight/obesity, and whether it identifies people most likely to benefit from an intensive lifestyle intervention (ILI) focused on weight loss and physical activity.<br /><br />Among 3,959 participants without prior heart failure, about 14.5% had elevated baseline NT-proBNP (125 pg/mL). Over a median 12.4 years, 212 heart failure events occurred, including HFpEF and HFrEF. Elevated baseline NT-proBNP was strongly associated with higher risk of both HFpEF and HFrEF, and each 1-SD higher baseline NT-proBNP also predicted greater risk. In the 3,653 participants with 1-year biomarker data and no interval heart failure, increasing NT-proBNP over 1 year was likewise associated with higher risk of both HF subtypes, even after adjusting for changes in blood pressure, kidney function, and lipids.<br /><br />The ILI did not reduce HFrEF risk. However, it did lower HFpEF risk in two groups: participants with elevated NT-proBNP at baseline, and those whose NT-proBNP was stable or decreasing at 1 year. There was no HFpEF benefit among participants with nonelevated baseline NT-proBNP or increasing NT-proBNP over time.<br /><br />Overall, the study suggests that NT-proBNP can help identify adults with type 2 diabetes at high risk for future HFpEF and HFrEF, and may also help select patients most likely to benefit from intensive lifestyle weight-loss interventions for HFpEF prevention.

Meta Tag

Concept NT-proBNP

Concept Heart Failure Risk

Concept Preserved Ejection Fraction

Concept Heart Failure with Reduced Ejection Fraction

Concept Intensive Lifestyle Modification

Keywords

NT-proBNP

heart failure

HFpEF

HFrEF

type 2 diabetes

overweight

obesity

intensive lifestyle intervention

weight loss

physical activity

NT-proBNP

Heart Failure Risk

Preserved Ejection Fraction

Heart Failure with Reduced Ejection Fraction

Intensive Lifestyle Modification