GP trainers' pay snub condemned
Heart failure diagnosis will be in the spotlight at the American College of Cardiology conference Cato Pedder reports
Researchers are calling for routine echocardiography screening for all rheumatoid arthritis patients after their study detected signs of heart failure in one in 10.
The UK study, to be presented at next month's American College of Cardiology conference in Orlando, found a doubled risk of left ventricular dysfunction in patients with rheumatic disease.
Using echocardiography to screen patients with rheumatoid arthritis could address the traditional 'under-investigation' of cardiac dysfunction in these patients, the cardiologists claimed.
The University of Birmingham study found 10.2 per cent of patients with rheumatoid arthritis had 'any' LVD, compared with 5.3 per cent of the general population. And 5.3 per cent of RA patients had 'definite' LVD, three times as many as in the population generally.
Study leader Dr Russell Davis, consultant cardiologist at Sandwell & West Birmingham Hospitals NHS Trust, said screening of patients with rheumatoid arthritis had a 10 per cent yield and was 'quite likely to be cost-effective'.
Dr Davis said up to one in every 800 patients, or 75,000 people nationwide, suffered from rheumatoid disease and should be screened for cardiovascular dysfunction.
He added that it was not known how often patients would need to be screened, but that an interval of five years between tests might be optimal.
Dr Iain Gilchrist, a GP in Hatfield Heath, Essex, and member of the Primary Care Rheumatology Society, said GPs should 'look on rheumatoid arthritis patients as equivalent to diabetics' in terms of cardiovascular risk.
But he warned that local echocardiography services were already overwhelmed.
Dr Davis said patients with rheumatoid arthritis were often under-investigated for cardiac dysfunction because they were unable to complete exercise testing. 'These patients get lots of aches in their chests anyway from rheumatic disease and they don't walk fast enough to get angina,' he said.