Screening with high efficiency, effectiveness and lower costs than the currently used approach
Al Arabiya.net – Jamal Nazi
Published on: 08 January 2024: 08:22 GST Last updated: 08 January 2024: 08:59 GST
A team of researchers has identified an efficient and cost-effective two-step screening strategy that, compared to the current one-step approach, more accurately identifies patients with type 2 diabetes who need treatment to prevent failure life-threatening cardiac failure, even those considered low-risk Risks only after follow-up. Clinical evaluation, according to New Atlas, citing Circulation.
A condition that worsens over time
Diabetes is a well-known risk factor for cardiovascular disease. Compared to people without diabetes, people with type 2 diabetes have a much higher risk of cardiovascular disease and mortality and are more than double the risk of developing heart failure, a serious condition that worsens over time and ultimately leads to death.
Screening for low-risk patients
A new study led by researchers at the University of Texas Southwestern Medical Center (UTSW) examined which screening protocols are most effective in identifying patients with type 2 diabetes who need drugs to prevent heart failure, even if considered low risk.
“Diabetes often leads to cardiovascular disease, and heart failure is one of the most common manifestations,” said Ambareesh Pandey, corresponding investigator of the study, noting that “in recent years many doctors have relied on one-shot screening methods phase”. such as clinical risk scores, vital sign tests, or echocardiography, to identify people at high risk of developing heart failure.
But even patients deemed low risk by single-step risk assessment tools sometimes develop heart failure. Furthermore, testing all individuals with diabetes using vital sign assessments or expensive ultrasound evaluations is often not possible or cost-effective.
The best screening protocols
The researchers examined data from 6,293 diabetics who participated in seven studies, including 4,889 who had no signs of cardiovascular disease, atherosclerosis, buildup of fat, cholesterol and other substances that can clog arteries, depriving the heart of blood and oxygen. .
By comparing screening methods and the risk of heart failure attacks at a five-year follow-up, the researchers identified the screening protocols that best predicted who was at risk.
Pandey said the study findings indicate that “30% to 50% of all cases of heart failure in people without prevalent cardiovascular disease occurred in individuals classified as low risk with a screening strategy. But when added a passage…” Secondly, about 85% of real cases of heart failure have been identified. This shows that a large percentage of diabetes patients who could benefit from more aggressive preventative treatment are being overlooked.”
Two steps for testing
Several two-stage screening protocols were evaluated, including the WATCH-DM score, which is a rapid assessment tool that predicts the risk of heart failure in a diabetic patient, and biomarkers in the blood, including natriuretic peptide levels, i.e. proteins produced when there is strenuous stretching of a muscle Cardiology, echocardiography, which uses sound waves to check the structure and function of the heart.
Natriuretic peptides
“Assessing the WATCH-DM risk score in all individuals, followed by natriuretic peptides only among individuals considered to be at low risk based on the WATCH-DM risk score, was found to be the most effective of the two-component screening strategies “Kershaw said. Patel, lead author of the study. In two phases.
Preventive treatments
Patel added that preventative treatments include sodium-glucose cotransporter SGLT2 inhibitors, originally known as drugs to control high blood glucose levels, which have become established as a key treatment for heart failure to protect heart health. A 2021 meta-analysis, including 15 studies and more than 20,000 patients, found that SGLT2 inhibitors significantly reduced all-cause mortality, cardiovascular mortality, and hospitalization for heart failure.
Echocardiography
Echocardiographic screening did not play a major role in the two-step approach proposed by the researchers. While useful for determining risk after clinical evaluation, ultrasound is more expensive and time-consuming than a blood test for natriuretic peptide, meaning it is unlikely to be screened unless the patient is already considered high risk or there is no other indication for this procedure.
Effective and low-cost tools
“The key to improving the ability to identify people who are most in need of preventive care is the use of cost-effective screening tools that can be easily implemented in the clinic,” Pandey said, noting that “our findings advance this search field”. .” “By demonstrating an efficient and effective approach, it gives doctors a better idea of the real risks to their patients.” The researchers hoped that further study of this two-step strategy would allow them to evaluate its clinical success and cost-effectiveness to develop a consistent approach for patients.
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2024-01-08 04:22:00
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