By Nigel Praities
NICE has toughened up its guidance on the diagnosis of heart failure, requiring GPs to carry out a B-type natriuretic peptide test in patients with suspected heart failure.
Previous guidance only required GPs to carry out a BNP test ‘where available' and was widely criticised by cardiology experts as it allowed patchy provision of the test across the country by PCTs.
The new guideline from NICE requires all patients with suspected heart failure who have not had a heart attack to be given a BNP test.
It also says patients who have very high BNP levels – and those patients with suspected heart failure and a previous myocardial infarction - should receive fast-track echocardiography and specialist assessment within two weeks.
As Pulse reported last year, a health technology assessment showed BNP testing was more accurate than electrocardiography. But the guidance still encourages GPs to send patients for an ECG to evaluate possible aggravating factors and/or alternative diagnoses.
Dr Mark Davis, a heart failure GPSI and a member of the guideline group, said the guidance would encourage better services for patients with heart failure.
‘It recognises the fact that having suffered a heart attack previously will markedly increase the risk of an individual developing heart failure and the use of BNP testing will help clinicians to identify other patients who are likely to have heart failure,' he said.BNP test required for suspected heart failure diagnosis