Factors associated with the risk of the incidence heart failure at 5 years in diabetic patients followed in Goma, Democratic Republic of the Congo

Abstract

Background: Brain natriuretic peptides (BNP) are considered highly sensitive markers in the diagnosis of heart failure (HF) and are associated with high morbidity and mortality but data on BNP predicting HF in sub-Saharan Africa are limited. The objective of this study was identify easily measured clinical factors associated with elevated BNP in patients with diabetes mellitus (DM), which may facilitate to prompt screening for HF. Methods: Asymptomatic diabetics in the city of Goma were cross-sectionally recruited at the Center of the Association of Diabetics in Congo (ADIC) in Goma during the period from February 5 to 19, 2023. The risk of incidence HF at 5 years was determined using BNP. A BNP value ≥50 pg/mL was considered a risk of incidence HF at 5 years. The best performing blood pressure (BP) component of the incidence of HF was assessed by the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Results: The frequency of patients with a BNP value ≥50 pg/mL expressing of the risk of incidence HF at 5 years was 29.98%. Analysis of the ROC curve showed that pulse pressure (PP) was the most important component of arterial pressure associated with a subsequent of BNP value ≥50 pg/mL. After adjusting for all these variables in a multiple logistic regression, age ≥40 years [adjusted odds ratio (aOR): 2.02, 95% confidence interval (CI): 1.03–3.04], female gender (aOR: 2.00, 95% CI: 1.24–3.25), PP ≥65 mmHg (aOR: 2.63, 95% CI: 1.83–3.99) and estimated glomerular filtration rate (eGFR) <60 mmHg (aOR: 1.99, 95% CI: 1.09–3.00) were the independent factors associated with the BNP value ≥50 pg/mL expressing the risk of incidence HF at 5 years in diabetics. Conclusions: The frequency of patients with a BNP value ≥50 pg/mL expressing the risk of HF is high in asymptomatic diabetics. It is associated with gender, age, PP and altered eGFR.