Diagnostic Tool Doubles Cardiovascular Diagnoses in Patients With COPD or Diabetes

A simple diagnostic strategy increased new cardiovascular disease diagnoses in patients with COPD or type 2 diabetes, urging its implementation in primary care.

An easy-to-use diagnostic strategy more than doubled the number of new diagnoses of cardiovascular disease in patients with COPD or type 2 diabetes. According to the authors, this diagnostic tool should be implemented in the management of patients with these conditions.

“Up to 40% of the patients with COPD or type 2 diabetes have unknown but treatable cardiovascular disease,” outlined Amy Groenewegen, MD, at ESC Congress 2023. “These patients are often symptomatic.” To reveal cardiovascular disease at an early stage in this population, Dr. Groenewegen and colleagues evaluated a diagnostic strategy in primary care patients with COPD, type 2 diabetes, or both. The RED-CVD trial was a cluster-randomized trial including 25 practices and 1,216 participants. The diagnostic intervention was a stepwise approach, starting with a symptom questionnaire, followed by a physical examination, NT-proBNP and ECG evaluations, and ended with a possible referral. The primary outcome measure was newly detected cardiovascular disease, including atrial fibrillation, heart failure, and coronary artery disease, at 1 year of follow-up.

In the usual-care arm, 3.0% of the participants had a diagnosis of a new cardiovascular disease compared with 8.0% in the intervention arm (OR, 2.83; 95% CI, 1.62–4.95). Dr. Groenewegen added that this effect was mainly driven by an increase in diagnoses of heart failure with preserved ejection fraction (3.2% vs 0.7%), atrial fibrillation (2.1% vs 0.8%), and relevant nonobstructive coronary artery disease (1.3% vs 0.2%) in the intervention arm.

“This easy-to-use diagnostic strategy led to a significant increase in diagnoses of new cardiovascular disease in patients with COPD and/or type 2 diabetes and should be considered to be implemented in the management of these patients in the primary care setting,” concluded Dr. Groenewegen.

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