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Too few heart failure patients diagnosed early

Tuesday November 30th 2021

Three quarters of people in the UK with heart failure could have been diagnosed sooner if they had received a simple, reliable blood test, a new report out today says.

Writing in the European Heart Journal, researchers from the University of Oxford say only one in four people had the natriuretic peptide test, which could have resulted in an earlier diagnosis at a more treatable stage.

According to NICE, GPs should use these tests to guide referral of patients showing symptoms of heart failure to a specialist for assessment.

The researchers used data from more than 1,400 general practices across the UK to examine how NP tests administered by GPs varied between 1 January 2004 and 31 December 2018.

First author Andrea Roalfe, senior researcher in medical statistics at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said: "We found that whilst NP test rates increased over time - with a significant upward trend in 2010 when NICE strengthened their recommendation to do this testing - the proportion of patients without NP testing prior to diagnosis remained high (reducing from 99.6% in 2004 to 76.7% in 2017), and most new diagnoses were made without an NP test."

They found most testing occurs in patients with more advanced disease, which suggests that progress has not been made in testing to achieve a timely diagnosis.

Dr Clare Taylor, a GP and NIHR academic clinical lecturer at the Nuffield Department of Primary Care Health Sciences, University of Oxford, said: "As GPs we can do a simple blood test in primary care which tells us if heart failure is likely.

"If it's raised, we can refer for a heart scan and assessment by a cardiologist. The heart failure detection rate in our study over a 14-year period remained the same, suggesting there are still missed opportunities for us to diagnose sooner through testing.

"There are many treatments that improve both quality of life and survival, but we need to give them earlier so patients benefit sooner and avoid hospitalisation, which is why this testing is so important."

The authors say GPs may need to carry out more NP testing, to prevent hospitalisation and help to diagnose HF at an earlier, more treatable stage. These tests should be done in people with heart failure symptoms, such as breathlessness, fatigue and ankle swelling.

Roalfe AK et al. Long term trends in natriuretic peptide testing for heart failure in UK primary care: a cohort study. 30 November 2021

[abstract]

Tags: Europe | Heart Health | UK News

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