STOP-HF
Trial question
What is the role of screening program using brain-type natriuretic peptide and collaborative care in patients with cardiovascular risk factors?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
55.0% female
45.0% male
N = 1374
1374 patients (751 female, 623 male).
Inclusion criteria: patients with cardiovascular risk factors.
Key exclusion criteria: refused to provide informed consent, LV systolic dysfunction, history of symptomatic HF, or diagnosis compromising survival.
Interventions
N=697 screening with BNP (with BNP ≥ 50 pg/mL undergoing echocardiography plus collaborative care between their primary care physician and specialist cardiovascular service).
N=677 no routine BNP screening (usual primary care).
Primary outcome
LV dysfunction with or without heart failure
5.3%
8.7%
8.7 %
6.5 %
4.3 %
2.2 %
0.0 %
Screening with
BNP
No routine BNP
screening
Significant
decrease ▼
NNT = 29
Significant decrease in LV dysfunction with or without HF (5.3% vs. 8.7%; OR 0.55, 95% CI 0.37 to 0.82).
Secondary outcomes
Significant decrease in emergency hospitalization for major CV events (per 1,000 patient-years) (22.3 vs. 40.4; IRR 0.6, 95% CI 0.45 to 0.81).
Significant decrease in asymptomatic LV dysfunction (4.3% vs. 6.6%; OR 0.57, 95% CI 0.37 to 0.88).
No significant difference in HF (1% vs. 2.1%; OR 0.48, 95% CI 0.2 to 1.2).
Conclusion
In patients with cardiovascular risk factors, screening with BNP was superior to no routine BNP screening with respect to LV dysfunction with or without HF.
Reference
Ledwidge M, Gallagher J, Conlon C et al. Natriuretic peptide-based screening and collaborative care for heart failure: the STOP-HF randomized trial. JAMA. 2013 Jul 3;310(1):66-74.
Open reference URL