Natriuretic peptide testing rates in UK primary care increased from 0.25 to 16.88 per 1000 person-years between 2004 and 2018, though 76.7% of patients still lacked testing prior to HF diagnosis.
Cohort (n=7,212,013)
Yes
Despite significant increases in natriuretic peptide testing in UK primary care since 2004, the vast majority of heart failure patients still do not receive an NP test prior to diagnosis, highlighting a gap in guideline implementation.
Absolute Event Rate: 16.88% vs 0.25%
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 2004-18 (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 an NP test recorded prior to diagnosis. More NP testing in primary care may be needed to prevent hospitalization and facilitate HF diagnosis at an earlier, more treatable stage.
Roalfe et al. (Mon,) conducted a cohort in Heart failure (n=7,212,013). Natriuretic peptide testing vs. Historical rates (2004 vs 2018) was evaluated on Trends in natriuretic peptide testing rates per 1000 person-years. Natriuretic peptide testing rates in UK primary care increased from 0.25 to 16.88 per 1000 person-years between 2004 and 2018, though 76.7% of patients still lacked testing prior to HF diagnosis.