Biomarkers for the prediction of heart failure and cardiovascular events in patients with type 2 diabetes: a position statement from the Heart Failure Association of the European Society of Cardiology
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Knowledge on risk predictors of incident heart failure (HF) in patients with type 2 diabetes (T2D) is crucial given the frequent coexistence of the two conditions and the fact that T2D doubles the risk of incident HF. In addition, HF is increasingly being recognized as an important endpoint in trials in T2D. On the other hand, the diagnostic and prognostic performance of established cardiovascular biomarkers may be modified by the presence of T2D. The present position paper, derived by an expert panel workshop organized by the Heart Failure Association of the European Society of Cardiology, summarizes the current knowledge and gaps in evidence regarding the use of a series of different biomarkers, reflecting various pathogenic pathways, for the prediction of incident HF and cardiovascular events in patients with T2D and in those with established HF and T2D.
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Values below BNP <35 pg/mL (threshold in atrial fibrillation <105 pg/mL) and NT-proBNP <125 pg/mL (threshold in atrial fibrillation <365 pg/mL) make the diagnosis of heart failure unlikely and other diagnoses should be considered.
“Values below the following cut-offs make the diagnosis of HF unlikely and other diagnoses should be considered: 483-485 ○ B-type natriuretic peptide (BNP) <35 pg/mL (threshold in AF: <105 pg/mL).○ NT-proBNP <125 pg/mL (threshold in AF: <365 pg/mL).”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [484]
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Colagiuri, S., & Ceriello, A. (2025) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2025.112150 · Cited by 3 · see citing works
Meta-Analysis of the Effect of Nursing Intervention on Children with Type 2 Diabetes
Tang, L., Xu, Z., Yao, P., & Zhu, H. (2022) · Computational and Mathematical Methods in Medicine · doi:10.1155/2022/6185739 · Cited by 1 · see citing works
RetractedJuly 2022 at a glance: focus on prognosis, devices and valvular heart disease
Tomasoni, D., Adamo, M., & Metra, M. (2022) · European Journal of Heart Failure · doi:10.1002/ejhf.2234
Self-citationCanagliflozin bei diabetischer Nierenerkrankung
Pavlicek, V. (2023) · Die Diabetologie · doi:10.1007/s11428-023-01110-8
Clinical and instrumental diagnosis of heart failure
Pedretti, R. F. E. (2024) · The Journal of AMD · doi:10.36171/jamd24.27.1.7
Clinical Perspectives for Diagnosis and Treatment of Diabetic CardiomyopathyPreprint
Chen, D., Sindone, A. P., Huang, M. L. H., Peter, K., & Jenkins, A. J. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5072684
Marx-Schütt, K. (2026) · Elsevier eBooks · doi:10.1016/b978-0-323-87862-3.00016-1
Zhao, Q.-J., Cai, X., Wang, X., & Jin, J. (2026) · Journal of Diabetes Investigation · doi:10.1111/jdi.70333
Diretriz Brasileira de Insuficiência Cardíaca – 2026
Simões, M. V., Moura, L. Z., Martins, S. M., Mourilhe‐Rocha, R., Danzmann, L. C., Neto, J. A. D. F., Marcondes‐Braga, F. G., de Oliveira, M. T., de Albuquerque, D. C., Freitas, A. F., et al. (2026) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20260830
- Authors
- Seferović, P., Farmakis, D., Bayes-Genis, A., Ben Gal, T., Böhm, M., Chioncel, O., Ferrari, R., Filippatos, G., Hill, L., Jankowska, E., Lainscak, M., Lopatin, Y., Lund, L. H., Mebazaa, A., Metra, M., Moura, B., Rosano, G., Thum, T., Voors, A., & Coats, A. J. S.
- Affiliations
- Serbian Academy of Sciences and Arts (RS)
- University of Cyprus (CY)
- Heart Institute, Hospital Universitari German Trias i Pujol , Badalona ,
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv ,
- Universitätsklinikum des Saarlandes (DE)
- Carol Davila University of Medicine and Pharmacy (RO)
- University of Ferrara (IT)
- National and Kapodistrian University of Athens (GR)
- Queen's University Belfast (GB)
- Wroclaw Medical University (PL)
- Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia, Faculty of Medicine, University of Ljubljana , Ljubljana ,
- Volgograd State Medical University, Regional Cardiology Centre Volgograd , Volgograd ,
- Karolinska University Hospital (SE)
- Inserm (FR)
- University of Brescia (IT)
- Centre for Health Technology and Services Research (PT)
- University of London (GB)
- Medizinische Hochschule Hannover (DE)
- University Medical Center Groningen (NL)
- University of Warwick (GB)
- Corresponding author
- Farmakis, Dimitrios
- ORCID
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-07-01
- Volume
- 24
- Issue
- 7
- Pages
- 1162-1170
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W4282943159
- Cited by
- 24
- References
- 65
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 11 · 2022: 2
- FWCI
- 3.66
- Type
- journal article
- Language
- en
- Update notices
- correction (2023-02-17)
- Open access
- bronze
- doi.org
- Licence
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Ulster University Research Portal (Ulster University) (publishedVersion, other-oa)
- Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Fraunhofer-Publica (Fraunhofer-Gesellschaft) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Warwick Research Archive Portal (University of Warwick) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- heart failure, type 2 diabetes, cardiovascular biomarkers, heart failure prediction, cardiovascular events, risk prediction, comorbidities, prognostic performance
- MeSH terms
- Cardiology, Diabetes Mellitus, Type 2, Heart Failure, Humans, Biomarkers
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