This observational study aims to evaluate whether measuring NT-proBNP (or BNP), either on its own or alongside the EPOF questionnaire, can improve the early detection of chronic heart failure (CHF) in adults aged 40 years or over who are referred for an outpatient cardiology evaluation and have no known or suspected CHF. The study will address the following questions: Does systematic NT-proBNP (or BNP) testing help to identify previously unrecognised CHF? Does combining NT-proBNP (or BNP) with the EPOF questionnaire enhance diagnostic accuracy compared with using each tool alone? Participants will attend their routine cardiology consultation, complete the EPOF questionnaire and undergo NT-proBNP (or BNP) testing as part of the clinical assessment. They will also allow the collection of relevant medical data. The diagnostic performance of these tools will then be compared with the final diagnosis made by the outpatient cardiologist. The study focuses on a population referred from primary care with increased cardiovascular risk. The early use of simple, accessible tools could reduce diagnostic delays, improve referral appropriateness and facilitate the earlier detection of CHF in general practice.
Study Type
OBSERVATIONAL
Enrollment
1,000
Private Cardiology Practice
Nîmes, France
Polyclinique de Poitiers - GCS ELSAN
Poitiers, France
Sensitivity of the combined EPOF questionnaire and natriuretic peptide strategy for detecting chronic heart failure
Sensitivity (with 95% confidence interval) of the combined screening strategy defined as a positive EPOF questionnaire (EPOF score ≥1) and/or a positive natriuretic peptide result (NT-proBNP ≥125 ng/L or BNP ≥35 ng/L), using the final diagnosis of chronic heart failure established by the treating cardiologist after completion of the routine diagnostic work-up as the reference standard.
Time frame: Baseline
Diagnostic performance of the EPOF questionnaire
Diagnostic performance of the EPOF questionnaire and each of its individual components, including sensitivity, specificity, positive predictive value, and negative predictive value with corresponding 95% confidence intervals, using the final diagnosis of chronic heart failure established by the treating cardiologist after completion of the routine diagnostic work-up as the reference standard.
Time frame: Baseline
Diagnostic performance of natriuretic peptide measurement
Diagnostic performance of a positive natriuretic peptide result (NT-proBNP ≥125 ng/L or BNP ≥35 ng/L), including sensitivity, specificity, positive predictive value, and negative predictive value with corresponding 95% confidence intervals, using the final diagnosis of chronic heart failure established by the treating cardiologist after completion of the routine diagnostic work-up as the reference standard.
Time frame: Baseline
Diagnostic performance of the combined EPOF + NT-proBNP strategy
Diagnostic performance of the combined screening strategy defined as a positive EPOF questionnaire (EPOF score ≥1) and/or a positive NT-proBNP result (≥125 ng/L), including sensitivity, specificity, positive predictive value, and negative predictive value with corresponding 95% confidence intervals, using the final diagnosis of chronic heart failure established by the treating cardiologist after completion of the routine diagnostic work-up as the reference standard.
Time frame: Baseline
Diagnostic performance of the combined EPOF + BNP strategy
Diagnostic performance of the combined screening strategy defined as a positive EPOF questionnaire (EPOF score ≥1) and/or a positive BNP result (≥35 ng/L), including sensitivity, specificity, positive predictive value, and negative predictive value with corresponding 95% confidence intervals, using the final diagnosis of chronic heart failure established by the treating cardiologist after completion of the routine diagnostic work-up as the reference standard.
Time frame: Baseline
Diagnostic performance in prespecified subgroups
Diagnostic performance of the EPOF questionnaire, natriuretic peptide measurement, and the combined screening strategies in prespecified exploratory subgroups defined by sex (men and women), age (40-59 years and ≥60 years), and body mass index (\<30 kg/m² and ≥30 kg/m²). Diagnostic performance measures include sensitivity, specificity, positive predictive value, and negative predictive value with corresponding 95% confidence intervals.
Time frame: Baseline
Prevalence of chronic heart failure
Prevalence of chronic heart failure, defined as the proportion of participants with a final diagnosis of chronic heart failure established by the treating cardiologist after completion of the routine diagnostic work-up, reported with the corresponding 95% confidence interval.
Time frame: Baseline
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