Nguyen K, Fan W, MD, Bertoni A, et al. - Among participants (n = 5,584) from the Multi-Ethnic Study of Atherosclerosis, researchers assessed the individual as well as combined links of N-terminal natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) levels with the development of incident heart failure (HF) and cardiovascular disease (CVD) events among asymptomatic adults with pre-diabetes (pre-DM) and diabetes mellitus (DM). Across quartiles of NT-proBNP and hs-cTnT, HF incidence rates per 1,000 person-years ranged from 3.2 to 39.4 and from 0.6 to 18.2, respectively, among those with DM. For CVD incidence per 1,000 person-years, the corresponding values ranged from 13.7 to 39.4 and from 13.2 to 35.4 for NT-proBNP and for hs-cTnT, respectively. The highest multivariate adjusted HRs were reported when both NT-proBNP and hs-cTnT were above than below the median in those with pre-DM/DM. In an ethnically diverse population, an improved risk prediction for both incident HF and total CVD events was achieved by combining both biomarkers to conventional risk factors among individuals who were normoglycemic or with pre-DM or DM.