Prediction or speculation: heart failure models for diabetes

European Journal of Heart Failure

Abstract

This editorial refers to ‘Performance of prediction models for incident heart failure and heart failure hospitalisation in individuals with type 2 diabetes: a systematic review and meta-analysis, by A. Mircescu et al., https://doi.org/10.1093/ejhf/xuag090. Among cardiovascular diseases, heart failure (HF) is one of the most frequent initial manifestations in individuals with diabetes.1 Despite this association, HF often remains undiagnosed in this patient population, even though diabetes is a well-established risk factor for HF.2 Early detection of HF in individuals with diabetes is therefore critical, as it allows for a timely diagnosis and early initiation of effective HF therapeutic strategies. Prediction models have the potential to identify patients with diabetes who are at high-risk of HF and HF hospitalization (HFH). In this issue of the journal, Mircescu and colleagues conducted a meta-analysis of randomized controlled trials, electronic health record-based studies and prospective cohorts that incorporated HF and HFH prediction models for persons with type 2 diabetes (T2DM).3 They identified 56 HF and 44 HFH prediction models. Despite this large number of models, only one model showed good discriminative performance for the prediction of HFH, and none have undergone prospective testing, minimizing the recommendation of their use in routine clinical practice. As a consequence, the clinical implications of these models are at best limited and prospective evaluation is required to establish clinical utility, as correctly stated by the authors.

Authors 4

1. Marlo Verket Aachen Department of Internal Medicine I Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Internal Medicine I, Medical Faculty, RWTH Aachen University , Pauwelsstr. 30, Aachen 52074 ,

2. Katharina Marx-Schütt Aachen Department of Internal Medicine I Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Internal Medicine I, Medical Faculty, RWTH Aachen University , Pauwelsstr. 30, Aachen 52074 ,

3. Hans‐Peter Brunner‐La Rocca

   Maastricht University Medical Centre

   Affiliation as printed

   Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM) , Maastricht ,

   Maastricht University Medical Centre (MUMC+) , Maastricht ,

4. Dirk Müller‐Wieland corresponding Aachen Department of Internal Medicine I Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Internal Medicine I, Medical Faculty, RWTH Aachen University , Pauwelsstr. 30, Aachen 52074 ,