Simple Blood Test May Predict Future Heart Risk

A simple blood test may predict the risk of progressive heart and kidney disease in people with Type 2 diabetes and kidney disease, according to new research published today in the American Heart Association’s flagship journal Circulation.

“Treatment with canagliflozin, a sodium glucose co-transporter 2 inhibitor, lowered biomarker levels and reduced the risk of hospitalization for heart failure and other heart complications in people at the highest risk.” said lead author James Januzzi, M.D.

Health professionals regularly measure biomarkers to screen, diagnose or treat specific conditions. Previous research has shown that concentrations of some biomarkers may predict the onset and progression of chronic kidney disease as well as cardiovascular events in people with Type 2 diabetes.

The researchers analyzed biomarker data from the blood samples of 2,627 people who participated in the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial to assess the effects of canagliflozin on concentrations of the four biomarkers from the study start, the one-year mark and the three-year mark. 

They also examined the prognostic value of each biomarker on various levels of kidney problems, and risk of death due to kidney disease or cardiovascular disease. 

The analysis found:

  • High concentrations of each biomarker at the beginning of the study were strongly predictive of the severity of the participant’s heart and kidney issues.
  • The concentrations of each of the four biomarkers in people taking canagliflozin were lower after one year and three years compared to those taking the placebo.

The CREDENCE trial (2014-2018) compared the effectiveness of a placebo to 100 mg of canagliflozin, which is used to treat Type 2 diabetes. It works in the kidneys to prevent the absorption of glucose. 

People enrolled in the phase 3 clinical trial had Type 2 diabetes and chronic kidney disease; the trial concluded canagliflozin was more effective than placebo in reducing cardiovascular disease and kidney failure in the participants.

The four biomarkers analyzed in the study were: N-terminal pro-B-type natriuretic peptide; high-sensitivity cardiac troponin T; growth differentiation factor-15; and insulin-like growth factor binding protein 7.


James L. Januzzi, Reza Mohebi, Yuxi Liu, Naveed Sattar, Hiddo J.L. Heerspink, Eshetu Tefera, Muthiah Vaduganathan, Javed Butler, Yshai Yavin, Jingwei Li, Carol A. Pollock, Vlado Perkovic, Bruce Neal, Michael K. Hansen. Cardiorenal Biomarkers, Canagliflozin, and Outcomes in Diabetic Kidney Disease: The CREDENCE Trial. Circulation, 2023; 148 (8): 651 DOI: 10.1161/CIRCULATIONAHA.123.065251

American Heart Association. (2023, August 21). Simple blood test may predict future heart, kidney risk for people with Type 2 diabetes. ScienceDaily. Retrieved August 21, 2023 from

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