Heart Failure, Congestive Clinical Trial
Official title:
A Randomised Trial of BNP Testing in Patients With Shortness of Breath in the Emergency Department to Improve Patient Outcome
A trial to examine whether a new heart failure blood test can improve the outcome of
patients presenting to the Emergency Department with shortness of breath.
We hypothesise that a BNP test performed in real-time in patients presenting to the
Emergency Department with shortness of breath will help identify additional patients with
CHF and consequently to change practice and allow more patients to recieve correct treatment
earlier.
In recent years new tests to diagnose heart failure have become available. We are evaluating
a new test called B-type natriuretic peptide(BNP)in patients presenting to the Emergency
Department with shortness of breath. Patients are randomised into whether they will receive
the new test or not. In the patient group where the test is positive, standardised approach
that will optimise heart failure treatment will be introduced. We hypothesise that with this
approach we will improve the clinical care of patients who present to the Emergency
Department with shortness of breath. Measures of outcomes will be the accuracy of diagnosis
2 hours after presentation, 30 day mortality, hospital and ICU admission rates and quality
of life at 30days.
We plan to investigate 600 consecutive patient presenting to the to the Emergency Department
with shortness of breath that are over 40 years old and present with an emergency department
triage category of 3 or higher. Patients presenting with a traumatic cause of dyspnea,
patients with severe renal disease, patients with cardiogenic shock and patients who have
early transfer to another hospital(within 24 hrs) will be excluded.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Diagnostic
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