Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

NIHR Academic Clinical Lecturer and GP Dr Clare Taylor gives a breakdown of the findings and their importance of a recent publication on heart failure and natriuretic peptide testing by herself and colleagues.

An infographic / visual abstract of the studies main findings and the authors conclusions

Heart failure is a malignant condition affecting almost a million people in the UK and has a worse prognosis than most cancers. Our analysis, published in the BMJ in 2019, showed that survival rates had not substantially improved in the previous two decades. Around 200,000 people receive a new diagnosis of heart failure each year and a recent British Heart Foundation report suggests there are significant delays in the current diagnostic pathway.

The National Institute for Health and Care Excellence (NICE) recommend a natriuretic peptide (NP) blood test for anyone presenting to primary care with symptoms of heart failure. If the level is raised, the patient requires referral for echocardiography and cardiology assessment. NICE recommend this should be completed within two weeks if the NP level is high (NT-proBNP>2000pg/ml).

In our study published today in Heart, we used linked primary and secondary care data from 40,000 patients with a new heart failure diagnosis to assess the association between initial NP result and subsequent hospitalisation and death.

Over half of patients were admitted to hospital in the year following diagnosis overall with a two-fold higher risk of admission due to heart failure in people with a high NP level. Death from any cause was also greater in the high NP group, with heart failure-related death 50% higher at 1, 5 and 10 years. The time from NP blood test to diagnosis was outside guideline recommended limits.

People with a high NP level in primary care are at increased risk of being admitted to hospital due to heart failure and have worse survival in the short and long term. These patients need to be diagnosed and treated quickly.

GPs currently have access to a ‘two-week wait’ referral pathway for patients with cancer symptoms. A similar compulsory two-week target may be needed for people with a high NP to facilitate timely heart failure diagnosis, and potentially reduce hospitalisations and improve survival.

You can read the full paper here: 10.1136/heartjnl-2021-319196 

Click here to download the full infographic (.pdf).

Twitter: @clarejtaylor

 

This work was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Oxford at Oxford Health NHS Foundation Trust , and the  NIHR Community Healthcare Medtech and In Vitro Diagnostics Co-operative, Oxford.  

Recent blog posts

The Future of Public Involvement

Dr Claire Schwartz, ARC OxTV Programme and PPI Manager, shares her thoughts on the future of patient and public involvement.

Working with SARAH (the Strengthening and Stretching for Rheumatoid Arthritis of the Hand programme)

Dr Esther Williamson reflects on her time developing the SARAH programme for people affected by Rheumatoid arthritis of the hand, the subject of a recent NIHR evidence Alert.

IF Festival catch up: Professor Cathy Creswell on 'Childhood anxiety – helping parents help their children'

Did you miss Cathy's talk for the IF Festival on 5th October? Good news! The session was recorded and you can view it here!

IF Festival catch up: Professor Susan Jebb on 'Why losing a few pounds may be good for you – and the NHS.'

Did you miss Susan's talk for the IF Festival on 5th October? Good news! The session was recorded and you can view it here!

COVID-19 lockdown: Mary Zacaroli

We asked PPI contributor Mary Zacaroli to let us know how the COVID-19 lockdown had affected her and the third sector and PPI work she does in her own words.