Early recognition of heart failure in patients with diabetes type 2 in primary care. A prospective diagnostic efficiency study. (UHFO-DM2)
| Autor: | Anho H. Liem, G. Ardine de Wit, Marcel A.J. Landman, Frans H. Rutten, Henk F. van Stel, Arno W. Hoes, Paulien A W van Hessen, Leandra J.M. Boonman-de Winter, Maarten J. Cramer, Guy E.H.M. Rutten |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Cost-Benefit Analysis Type 2 diabetes Internal medicine Diabetes mellitus Study protocol Epidemiology Prevalence Natriuretic peptide Humans Medicine Prospective Studies Prospective cohort study Intensive care medicine Aged Netherlands Heart Failure Primary Health Care medicine.diagnostic_test business.industry lcsh:Public aspects of medicine Public Health Environmental and Occupational Health lcsh:RA1-1270 Cost-effectiveness analysis Middle Aged medicine.disease Diagnostic Services Early Diagnosis Diabetes Mellitus Type 2 Heart failure Cardiology Female business Electrocardiography |
| Zdroj: | BMC Public Health, Vol 9, Iss 1, p 479 (2009) BMC Public Health |
| ISSN: | 1471-2458 |
| Popis: | Background We hypothesize that the prevalence of unknown heart failure in diabetic patients aged 60 years and over is relatively high (15% or more) and that a cost-effective strategy can be developed to detect heart failure in these patients. The strategy is expected to include some signs and symptoms (such as dyspnoea, orthopnoea, pulmonary crepitations and laterally displaced apical beat), natriuretic peptide measurements (Amino-terminal B-type natriuretic peptide) and possibly electrocardiography. In a subset of patients straightforward echocardiography may show to be cost-effective. With information from our study the detection of previously unknown heart failure in diabetic patients could be improved and enable the physician to initiate beneficial morbidity and mortality reducing heart failure treatment more timely. Primary objectives - To assess the prevalence of (previously unrecognised) heart failure in primary care patients with diabetes type 2. - To establish the most cost-effective diagnostic strategy to detect unrecognised heart failure in these patients. Secondary objectives - To assess the impact of heart failure, and the combination of a new diagnosis with accordingly treatment in patients with diabetes type 2 on health status. Methods/Design Design: A prospective diagnostic efficiency study. Patient population: Patients aged 60 years and older with diabetes type 2 from primary care, enlisted with the diabetes service of the Diagnostic Center in Etten-Leur (SHL) All participants will be investigated at the cardiology out-patient department of the regional hospital (Oosterschelde Hospital in Goes, Zeeland, the Netherlands) during a single 1.5 hour standardised diagnostic assessment, including history taking, physical examination, electrocardiography, echocardiography, blood tests, and Health status questionnaires. Patients will be asked if we can contact them afterwards for follow-up and for repeating the questionnaires after three and 12 months. Main study parameters/endpoints: Prevalence (with exact 95% confidence intervals) of (previously unrecognised) heart failure (systolic and 'isolated' diastolic) and the diagnostic value of signs and symptoms, NT-proBNP, electrocardiography and a combination of these items. The cost-effectiveness of different diagnostic strategies. Impact of heart failure and the combination of a new diagnosis with accordingly treatment on health status. Trial registration CCMO register NL2271704108 |
| Databáze: | OpenAIRE |
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