Early Detection and IntervenTion in Heart Failure

Summary

Heart failure (HF) occurs when the heart is no longer able to pump blood effectively throughout the body. This leads to symptoms that gradually worsen over time and are often mistaken for normal signs of aging. Because of its insidious onset, early detection is challenging. Both patients and healthcare professionals are often insufficiently aware of the early signs and symptoms of HF, resulting in delayed diagnosis. Consequently, timely initiation of treatments that could slow disease progression, improve quality of life, and reduce hospitalizations is often missed. Although a simple blood test measuring NT-proBNP levels can facilitate the early diagnosis of HF, it is not routinely used in clinical practice. The aim of this study is to evaluate whether a combined strategy for the early diagnosis and treatment of HF can reduce hospitalizations. This strategy includes: 1. increasing awareness of HF among patients and physicians, 2. using NT-proBNP testing for the early detection of HF in high-risk patients, and 3. promptly initiating guideline-directed HF treatment when the diagnosis is confirmed. The researchers will assess whether this strategy effectively reduces hospitalizations due to acute heart failure over an 18-month follow-up period.

Eligibility

Inclusion Criteria:

* General consent (GC) has not been rejected.
* Age ≥ 65 years.
* Elective percutaneous coronary intervention\* (PCI), pulmonary vein isolation\* (PVI), pacemaker implantation\* (PM, no cardiac resynchronisation), transcatheter aortic valve intervention\* (TAVI), major non-cardiac surgery\* or presenting with tachyarrhythmia to the emergency department (ED) (without a diagnosis of HF within 24h).

  * Exclusion criteria are assessed on day 1 after the procedure

Exclusion Criteria:

* Systolic blood pressure ≤ 95 mmHg
* Estimated glomerular filtration rate (GFR) \<30 mL/min/1.73 m2.
* Dementia documented in the medical history.
* Metastatic cancer in the medical history.
* Previously enrolled in this study.
* Known HF.
* Known allergies, hypersensitivity, or intolerance to SGLT2 Inhibitors / Loop Diuretics / MRA or is excipients.
* Non-resident in the country of the recruiting site
* Incapacity of the patient to make judgements
* Patients not hospitalized overnight
* Patients requiring intensive care unit (ICU) or intermediate care (IMC) stay beyond 11:00 a.m. on the first postoperative day or any post-interventional stroke unit stay until 8:00 a.m. on the first postoperative day.
* Patients died prior to postinterventional day 1 (8:00 a.m.)
* Severe aortic or mitral stenosis

Conditions2

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