Journal article
Long term trends in natriuretic peptide testing for heart failure in UK primary care: a cohort study
- Abstract:
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Aims: Heart failure (HF) is a malignant condition with poor outcomes and is often diagnosed on emergency hospital admission. Natriuretic peptide (NP) testing in primary care is recommended in international guidelines to facilitate timely diagnosis. We aimed to report contemporary trends in NP testing and subsequent HF diagnosis rates over time.
Methods and Results: Cohort study using linked primary and secondary care data of adult (≥45 years) patients in England 2004-2018 (n=7,212,013, 48% male) to report trends in NP testing (over time, by age, sex, ethnicity, and socioeconomic status) and HF diagnosis rates. NP test rates increased from 0.25 per 1000 person-years [95% confidence interval (CI) 0.23-0.26] in 2004 to 16.88 per 1000 person-years (95% CI 16.73-17.03) in 2018, with a significant upward trend in 2010 following publication of national HF guidance. Women and different ethnic groups had similar test rates, and there was more NP testing in older and more socially deprived groups as expected. The HF detection rate was constant over the study period (around 10%) and the proportion of patients without NP testing prior to diagnosis remained high [99.6% (n=13,484) in 2004 vs 76.7% (n=12,978) in 2017].
Conclusion: NP testing in primary care has increased over time, with no evidence of significant inequalities, but most patients with HF still do not have a NP test recorded prior to diagnosis. More NP testing in primary care may be needed to prevent hospitalisation and facilitate HF diagnosis at an earlier, more treatable stage.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.2MB, Terms of use)
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- Publisher copy:
- 10.1093/eurheartj/ehab781
Authors
- Publisher:
- Oxford University Press
- Journal:
- European Heart Journal More from this journal
- Volume:
- 43
- Issue:
- 9
- Pages:
- 881–891
- Publication date:
- 2021-11-30
- Acceptance date:
- 2021-10-28
- DOI:
- EISSN:
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1522-9645
- ISSN:
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0195-668X
- Language:
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English
- Keywords:
- Pubs id:
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1206213
- Local pid:
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pubs:1206213
- Deposit date:
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2021-11-01
- ARK identifier:
Terms of use
- Copyright holder:
- Roalfe et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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