ACC: BNP-Guided Screening and Treatment Aids Heart Failure

B-type natriuretic peptide-guided screening, shared-care treatment beneficial for older at-risk patients

TUESDAY, March 12 (HealthDay News) -- For older adults at risk of heart failure, B-type natriuretic peptide (NP)-guided screening and shared-care treatment is associated with a reduction in the prevalence of left ventricular dysfunction and heart failure, according to a study presented at the annual meeting of the American College of Cardiology, held from March 9 to 11 in San Francisco.

Mark T. Ledwidge, Ph.D., from St. Vincent's University Hospital in Dublin, Ireland, and colleagues conducted a prospective randomized trial to evaluate NP-guided screening and shared-care treatment for 1,235 asymptomatic patients (mean age, 64.7 years) with risk factors for heart failure. Participants were recruited from 39 family practices and were screened at least once a year for cardiovascular risk and plasma NP. Patients in the intervention group received echocardiography and care shared between the family physician and specialist cardiology service if their B-type NP level was over 50 pg/mL, while controls received usual care.

The researchers found that 41.6 percent of intervention patients experienced elevated NP at any time. The prevalence of left ventricular dysfunction and heart failure was 9.7 percent for controls and 5.9 percent for patients in the intervention group (relative risk, 0.58; P = 0.013). The incidence rate of emergency hospitalization for major cardiovascular events was significantly lower in the intervention group (24.4 versus 45.2 per 1,000 patient-years; relative risk, 0.54).

"Our study shows that a simple blood test screening, followed by targeted care of people at heightened risk of heart failure, can result in a dramatic reduction in cardiovascular events," a coauthor said in a statement.

The STOP-HF trial was partially funded by the Heartbeat Trust, which received unrestricted grants from various pharmaceutical companies.

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