One of the most serious potential risks for patients diagnosed with type 2 diabetes is heart failure leading to death or disability. But a new study by investigators from Brigham and Women's Hospital and UT Southwestern Medical Center has indicated AI can predict future heart failure with a high degree of accuracy.

The findings were presented at the recent Heart Failure Society of America Annual Scientific Meeting in Philadelphia and simultaneously published in the journal Diabetes Care.

“Our risk score provides a novel prediction tool to identify patients who face a heart failure risk in the next five years,” said co-first author Matthew Segar, MD, MS, a resident physician at UT Southwestern. “By not requiring specific clinical cardiovascular biomarkers or advanced imaging, this risk score is readily integrable into bedside practice or electronic health record systems and may identify patients who would benefit from therapeutic interventions.”

Data from 8,756 patients with diabetes enrolled in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial was used for development of the risk score, called WATCH-DM. These data included a total of 147 variables, including demographics, clinical information, laboratory data and more. The investigators used machine-learning methods capable of handling multidimensional data to determine the top-performing predictors of heart failure.

Over the course of almost five years, 319 patients (3.6 percent) developed heart failure. The team identified the 10 top-performing predictors of heart failure, which make up the WATCH-DM risk score, including weight (BMI), age and hypertension.

“BMI was one of the top predictors of heart failure risk, which reinforces the idea that long-term excess weight may increase future risk for heart failure. We hope this work highlights ways to intervene – both through lifestyle changes and through the use of SGLT2 inhibitors – to delay or even entirely prevent heart failure,” said co-first author Muthiah Vaduganathan, MD, MPH, a cardiologist at the Brigham.

The study is considered strong given its large sample size and the high rate of heart failure, but the authors note that their findings may be constrained by certain limitations. The ACCORD trial was conducted between 1999 and 2009, and predictors of heart failure may have evolved since the trial's conclusion. 

Perhaps most importantly, the WATCH-DM risk score is now available as an online tool for clinicians to use. As a next step, the research team is working to integrate the risk score into electronic health record systems at both the Brigham and UT Southwestern to facilitate its practical use.