Presentation (CTI)

OBJECTIVES: Heart failure (HF) is a chronic, progressive condition with a high clinical and economic burden. Early diagnosis and timely treatment are critical to improving patient outcomes and reducing healthcare costs. This analysis evaluated two complementary diagnostic and treatment optimization pathways integrating N terminal pro B type natriuretic peptide (NT proBNP) testing via Point-of-Care (PoC) devices: a primary care based general practitioner (GP) pathway and a specialist pathway. To assess the clinical and economic impact of implementing NT proBNP based early diagnosis and treatment optimization pathways for heart failure in real world settings.
METHODS: In the GP pathway, general practitioners used NT proBNP testing to identify patients at risk of HF and refer them for echocardiographic confirmation. In the specialist pathway, cardiologistsperformed both NT proBNP testing and diagnostic confirmation. Pre and post intervention surveys captured data on diagnostic timelines, therapy initiation, and clinical management. A cost analysis was conducted to estimate the economic consequences of earlier diagnosis and optimized care.
RESULTS: NT proBNP testing reduced the average diagnostic timeline from approximately three months to just over one week. Both pathways led to faster initiation of evidence based therapies and improved adherence to clinical guidelines. The economic analysis projected annual cost savings of approximately €10 million for the national healthcare system, including over €4.8 million for patients with preserved ejection fraction.
CONCLUSIONS: Incorporating NT proBNP testing in primary and specialist care settings facilitates earlier diagnosis and improved therapeutic management of heart failure. These pathways enhance clinical outcomes and generate substantial healthcare savings. Broad implementation of this model may improve health system efficiency and patient prognosis across the HF population.