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Plans for larger scale targeted systematic screenings could diagnose thousands

When applied at a larger scale, such an approach could translate into tens of thousands of new diagnoses, researchers believe.

Conditions such as coronary artery disease, atrial fibrillation and heart failure affect millions of people worldwide, causing a large number of deaths and increasing healthcare costs.

Treatments are available that can prevent stroke or acute heart failure, but systematic screening is not currently common practice.

Those living with conditions such as type 2 diabetes or chronic obstructive pulmonary disease (COPD) – a group of lung conditions that cause breathing difficulties – are at high risk of such conditions.

A team of researchers led by Dr Amy Groenewegen, from the University Medical Centre Utrecht in the Netherlands, has developed a three-step screening process to detect conditions in high-risk people at an early stage.

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Study author Dr Groenewegen said: “An easy-to-implement strategy more than doubled the number of new diagnoses of heart failure, atrial fibrillation and coronary artery disease in high-risk patients.”

The first step of the team’s intervention was getting patients at primary care practices across the Netherlands to fill out a questionnaire on risk factors and symptoms.

Patients who scored above a specified threshold were given a physical examination by a practice nurse focused on signs of heart failure, as well as an ECG and blood test.

Finally, test results were assessed by a GP who referred patients to a cardiologist when it was deemed necessary.

Between June 2019 and January 2023, 1,216 patients took part in the study, of whom 87 percent had type 2 diabetes and 20 percent had COPD.

Half of the patients were subjected to the new screening process, with the other half forming a control group.

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After a year, 50 of the 624 participants (8.0 percent) in the intervention group were newly diagnosed with at least one of heart failure, atrial fibrillation or coronary artery disease.

Only 19 of the 592 participants (3.2 percent) in the control group were diagnosed.

Dr Groenewegen said: “Because there are so many adults in the community with COPD or type 2 diabetes, this approach could translate into tens of thousands of new diagnoses when applied at large.

“In the Netherlands, for example, screening the more than 920,000 patients with COPD and/or type 2 diabetes could identify over 44,000 patients with at least one previously undiagnosed cardiovascular condition.”

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  • Posted on August 28, 2023