Active detection of cardiovascular disease in patients with COPD or type 2 diabetes
RED-CVD: Proactive diagnostic strategy more than doubled new CVD diagnoses
Active screening of patients with type 2 diabetes or chronic obstructive pulmonary disease (COPD) more than doubled new diagnoses of cardiovascular disease compared to usual care, according to results from the RED-CVD trial presented at ESC Congress 2023.
The trial included 1,216 patients , of whom were approximately 68 years of age, 87% had type 2 diabetes, 40% were women, and 20% had COPD. Participants were assigned to 25 primary care practices in the Netherlands that were randomly assigned to provide routine care (control group) or to add an early diagnosis strategy to their usual disease management programs for type 2 diabetes and COPD (intervention group).
The intervention involved three steps:
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The primary outcome was a composite of newly detected cases of heart failure, atrial fibrillation (AFib), and coronary artery disease (CAD) one year after the baseline visit. Secondary endpoints included newly initiated treatments one year after the baseline visit.
At one year, 50 of 624 patients in the intervention group and 19 of 592 patients in the control group were newly diagnosed with at least one of the following: heart failure, atrial fibrillation, or coronary artery disease. The researchers noted that HF was the most common new diagnosis (4.5%) in the intervention group, followed by coronary heart disease (CAD) (2.6%) and atrial fibrillation (AFib) (2.1%). These percentages were more than double those of the control group.
No significant differences in medication use were observed during follow-up between the intervention and control groups.
"An easy-to-implement strategy more than doubled the number of new diagnoses of heart failure, atrial fibrillation and coronary heart disease in high-risk patients," said Dr. Amy Groenewegen, of the University Medical Center Utrecht, the Netherlands. "Because there are so many adults in the community with COPD or type 2 diabetes, this approach could translate into tens of thousands of new diagnoses when applied broadly. In the Netherlands, for example, more than "920,000 patients with COPD and/or type 2 diabetes could identify more than 44,000 patients with at least one previously undiagnosed cardiovascular condition."
