SCReening Evaluation of the Evolution of New Heart Failure
Heart failure (HF) affects approximately half a million Australians, being more common in the elderly. The prevalence of HF is increasing at least in part due to the ageing population and better survival in patients with cardiovascular disease. However general practitioners often find it quite difficult, particularly in the early stages, to diagnose heart failure due to the lack of specificity of symptoms, and because it is frequently masked by other conditions. To better target currently available preventive therapies, there is the need to improve identification of individuals at increased risk of developing HF.
The SCREEN-HF study, enrolling 4,000 individuals, was Australia's largest longitudinal community-based study of the evolution of heart failure (HF) and other cardiovascular events. The study’s aim was to evaluate the use of serum amino-terminal pro-B-type natriuretic peptide (NT-proBNP) for stratification of risk for HF and other cardiovascular events. Using echocardiographic analysis, it also examined the evolution of (LVD) in this study population.
NT-proBNP was measured in ~3,500 individuals at a baseline echo visit with another ~2,500 attending repeat echocardiograms approximately 5 years after enrolment. Blood samples were collected at the time of the initial and subsequent echocardiogram visits and are stored in a -80 freezer. Ethics approval was gained from the AIHW to undertake data linkage with the National Death Index.
Age-specific serum NT-proBNP cut-points were identified with the potential to inform prognostic and therapeutic decisions regarding HF risk. Moreover, these cut-points identified increased HF risk for at least 6 years into the future, indicating that an appropriate interval between NT-proBNP measurements to identify HF risk is 4–5 years.
National Heart Foundation Grant (NHF) Vanguard grant was received by Screen-HF investigators for 2020–2022 to measure high sensitivity cardiac troponin I (hs-cTnI) in the Screen-HF cohort stored blood samples to examine whether hs-cTnI predicts incremental prediction of cardiovascular events including heart failure beyond that provided by NT-proBNP and clinical risk factors. A subsequent aim is to plan translation of the new prediction models to the clinic, particularly Primary Care, and then to validate these models.
The study funded by BUPA and two grants from NHMRC and NHF Vanguard grant.