Predictors of Incident Heart Failure Diagnosis Setting

Tisdale, Rebecca; Fan, Jun; Calma, Jamie; Cyr, Kevin; Podchiyska, Tanya; Stafford, Randall S; Maron, David J.; Hernandez‐Boussard, Tina; Ambrosy, Andrew P.; Heidenreich, Paul A.; Sandhu, Alexander T.

doi:10.1016/j.jchf.2022.11.013

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…They also reported that about half of all these patients had potential HF symptoms within 6 months of diagnosis. Similarly, Tisdale et al 13 . found that approximately 53% of all new HF diagnoses in the Veteran Affairs healthcare system occurred in an acute care setting with 44% of patients with potential HF symptoms in the year prior to diagnosis.…”

Section: Discussionmentioning

confidence: 94%

“…They also reported that about half of all these patients had potential HF symptoms within 6 months of diagnosis. Similarly, Tisdale et al 13 found that approximately 53% of all new HF diagnoses in the Veteran Affairs healthcare system occurred in an acute care setting with 44% of patients with potential HF symptoms in the year prior to diagnosis. Patients diagnosed in the inpatient setting tend to be older, have more comorbidities, are socioeconomically vulnerable, and have poor outpatient care compared to patients diagnosed in the outpatient setting.…”

Section: Discussionmentioning

confidence: 95%

“…A contemporary analysis from the Veterans Affairs healthcare system revealed that only 11% of all patients with an inpatient HF diagnosis underwent NP testing the year before diagnosis, of which approximately 90% of the measurements were elevated. 13 Low use of diagnostic testing may also contribute towards high inpatient diagnoses as patients may not be accurately or timely diagnosed in the outpatient setting, resulting in worsening disease severity necessitating hospitalization for acute HF. Patients who experience delays in diagnostic testing are likely to be more symptomatic, take more medications, experience greater healthcare utilization, and have a higher burden of comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly problematic in the outpatient setting where prompt recognition and treatment of earlier stage HF might be expected to reduce the risk for hospitalization. A contemporary analysis from the Veterans Affairs healthcare system revealed that only 11% of all patients with an inpatient HF diagnosis underwent NP testing the year before diagnosis, of which approximately 90% of the measurements were elevated 13 . Low use of diagnostic testing may also contribute towards high inpatient diagnoses as patients may not be accurately or timely diagnosed in the outpatient setting, resulting in worsening disease severity necessitating hospitalization for acute HF.…”

Section: Discussionmentioning

confidence: 99%

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Use of natriuretic peptides and echocardiography for diagnosing heart failure

Talha,

Januzzi,

Meng

et al. 2024

European J of Heart Fail

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AimsInternational guidelines have recommended the use of echocardiography and natriuretic peptides (NP) testing in the diagnostic evaluation of heart failure (HF) for more than 10 years. However, real‐world utilization of these diagnostic tests in the US is not known. We sought to assess contemporary trends in echocardiography and NP testing for diagnosing HF in the US.Methods and resultsThe TriNetX data were queried for the total number of first HF diagnoses in adults aged >18 years in the US from 2016 to 2019 with exclusions applied. NP testing and echocardiography any time before through 1 year following the index diagnosis were assessed. Temporal trends significance was evaluated using Cochran–Armitage trend tests. A total of 124 126 patients were included. Mean age was 68 ± 13 years, 53% were male, and 71% were White. Overall, 61 023 (49%) incident diagnoses were made in the outpatient and 63 103 (51%) in the inpatient setting with a significantly increasing trend toward inpatient diagnoses (p < 0.001). Of all incident HF diagnoses, 70 612 (57%) underwent echocardiography, 67 991 (55%) underwent NP testing, and 31 206 (25%) did not undergo either diagnostic test. There were increasing trends in the proportion of patients diagnosed in the inpatient versus outpatient setting that underwent echocardiography, NP testing, and either diagnostic test (p < 0.001 for all).ConclusionsWe found low rates of echocardiography and NP testing in those with HF, with more of such testing performed amongst inpatient diagnoses. We also found increasing rates of inpatient HF diagnoses, indicating lost opportunities for earlier treatment initiation and better outcomes.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Use of natriuretic peptides and echocardiography for diagnosing heart failure

Talha,

Januzzi,

Meng

et al. 2024

European J of Heart Fail

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“…31 Similar patterns of delayed diagnosis of heart failure have been noted in the US and Canada. [32][33][34] Minimizing the morbidity of heart failure requires increased awareness among patients and primary care clinicians, as well as additional strategies to facilitate disease recognition.…”

Section: Survivalmentioning

confidence: 99%

Advances in management of heart failure

Heidenreich,

Sandhu

2024

BMJ

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Heart failure is increasing in prevalence in many countries with aging populations. Fortunately, remarkable scientific advances have been made in the past few years that have led to new treatments and improved prognosis for patients with heart failure. This review examines these changes with a focus on the diagnosis and medical management of heart failure. The changes include the increase to four foundational drug classes (pillars of therapy) now recommended for patients with heart failure and reduced left ventricular ejection fraction, use of sodium-glucose cotransporter-2 inhibitors for those with a higher ejection fraction, and the importance of rapid initiation of life prolonging therapies once a diagnosis of heart failure has been made. Device management and other non-drug management have also evolved with the publication of new clinical trials. The review emphasizes evidence published since the recent heart failure guidelines of the European Society of Cardiology and American College of Cardiology/American Heart Association/Heart Failure Society of America in 2021 and 2022. Additional studies are needed to determine how best to implement these new interventions in clinical practice.

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Setting the Diagnosis of Heart Failure

Sepehrvand

2023

JACC: Heart Failure

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Predictors of Incident Heart Failure Diagnosis Setting

Cited by 5 publications

References 27 publications

Use of natriuretic peptides and echocardiography for diagnosing heart failure

Use of natriuretic peptides and echocardiography for diagnosing heart failure

Advances in management of heart failure

Setting the Diagnosis of Heart Failure

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