CARDIOLOGY
developing to an accurate diagnosis and the start of life-saving therapy. We have these tools – and we must start using them properly right across the country.” Nick Hartshorne-Evans, chief executive
of the Pumping Marvellous Foundation, pointed out that, with COVID-19, the situation is only going to become worse, with an increasing backlog and strained services. “Delays to diagnosis mean delays to treatment and pressing pause on the life that people living with heart failure can have and, importantly, deserve. We must urgently use the tools at our disposal and work together to create a diagnostic pathway that works for patients and healthcare professionals alike. The positive impact of this on patients and their families will be transformative, when we get it right,” he commented. Cardiac lead at Roche Diagnostics UK and Ireland, Siobhan Brown, also highlighted the urgent need to come together as a community to remove the gender inequalities identified in the report. “Timely and accurate diagnosis has the potential to save lives, reduce pressure on the NHS and improve quality of life in the long-term. But it can only be effective if those suspected of heart failure have access to the right test at the right time,” she asserted.
Concluding, Dr. Jim Moore, president
of the Primary Care Cardiovascular Society, and GP and GPSI in cardiology (GLOS Heart Failure Service), said: “In the context of a NHS committed to reducing health inequality, the gender differences highlighted in this document are both unexpected and alarming. It is critical that we take stock of these findings while seeking to understand why women appear to be significantly disadvantaged when making a timely, accurate diagnosis of heart failure and commit to taking urgent action to address this.
“Delay in diagnosis is particularly relevant to primary care and, though the presenting symptoms of heart failure are non-specific and commonly seen in other conditions, there is clear evidence that this diagnosis is not being considered at an early stage where investigations such as natriuretic peptide testing (NT-proBNP) are critical to further assessment and, where indicated, urgent referral. Access in primary care to NT-proBNP may not be universal but the use of the test when available appears to be highly variable and another important factor in late diagnosis.
“COVID-19 has led to significant changes in service delivery in primary care, altering the ways in which we consult and adding to the challenges faced in making a timely diagnosis of heart failure,
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therefore the widespread use of cost-effective diagnostic tools such as NT-proBNP must be our priority to save lives, reduce costs and improve patients’ quality of life in the future.” The report was prepared by Roche Diagnostics and the Pumping Marvellous Foundation. To view the full report, visit:
https://dianews.roche.com/heart-failure-
report.html
CSJ
References 1 NICE, Clinical guidance: Chronic heart failure in adults: diagnosis and management (NG106) (2018),
https://www.nice.org.uk/guidance/ ng106/chapter/Recommendations#diagnosing- heart-failure; NICE, Clinical guidance: Acute heart failure: diagnosis and management (2014),
https://www.nice.org.uk/guidance/cg187.
2 NICE, Costing statement: Acute heart failure Implementing the NICE guideline on acute heart failure (CG187) (2014).
https://www.nice.org.uk/
guidance/CG187/resources/cg187-acute-heart- failure-costing-statement pages 6-8. Accessed 11 August 2020.
3 NICE, Resource impact report: Chronic heart failure in adults: diagnosis and management (NG106) (2018),
https://www.nice.org.uk/guidance/ ng106/resources/resource-impact-report- pdf-6537494413
4 Personal Social Services Research Unit, Community- Based Health Care Staff (2018),
https://www.pssru.
ac.uk/pub/uc/uc2018/community-based-health- care-staff.pdf
5 Nursing Times, Heart failure mortality risk ‘worse than for some cancers’ (2017), https://www.
nursingtimes.net/news/research-and-innovation/ heart-failure-mortality-risk-worse-than-for-some- cancers-10-05-2017/
6 Mamas, M.A., et al., Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland. Eur J Heart Fail, 2017. 19(9): p. 1095-1104.
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