{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T19:44:05Z","timestamp":1767987845621,"version":"3.49.0"},"reference-count":21,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,12,15]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Heart failure (HF) is common with high associated morbidity and mortality. UK National Institute for Health and Clinical Excellence (NICE) Guidelines suggest prioritising assessment by natriuretic peptide (NP) level, with patients with high NP levels assessed within 2\u2009weeks. We evaluated adherence to NICE guidelines in the post-COVID-19 era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective audit of consecutive referrals to a HF diagnostic pathway across seven hospitals in the West of Scotland (between 5\u202fJanuary and 2\u202fJune\u202f2022). Patients were categorised by NP level according to NICE Guidelines: NT-proBNP 400\u20132000\u2009ng\/L (echocardiogram within 6\u2009weeks) or &gt;2000\u2009ng\/L (echocardiogram within 2\u2009weeks). Time-to-echocardiogram was recorded, and 1-year outcomes (HF hospitalisation, death) were obtained from electronic records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 899 patients (median age 79 years, 56% female) referred for echocardiography on the HF diagnostic pathway, 264 (29%) and 635 (71%) had an NT-proBNP &gt;2000\u2009ng\/L and 400\u20132000\u2009ng\/L, respectively. Only 20 (8%) patients with NT-proBNP &gt;2000\u2009ng\/L and 51 (8%) patients with NT-proBNP 400\u20132000\u2009ng\/L received an echocardiogram within the recommended timeframe. 252 (28%) patients were diagnosed with HF, 110 (42%) and 142 (22%) in the NT-proBNP &gt;2000\u2009ng\/L and 400\u20132000\u2009ng\/L groups, respectively, p&lt;0.001. One-year mortality was 12% and was higher in the &gt;2000\u2009ng\/L NT-proBNP group at 21% compared with 9% in the 400\u20132000\u2009ng\/L group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High NP levels identified a high-risk group who are more likely to have HF and a higher risk of mortality. Few patients received echocardiography within the NICE Guideline-recommended timeframe. Patients with high NP levels should be investigated with the same urgency as suspected cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003785","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:40:24Z","timestamp":1767969624000},"page":"e003785","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Post-COVID-19 era heart failure diagnosis and outcomes: adherence to National Institute for Health and Care Excellence Guidelines"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7580-2069","authenticated-orcid":false,"given":"Usmaan B","family":"Razzaq","sequence":"first","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5446-9969","authenticated-orcid":false,"given":"Kieran F","family":"Docherty","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"},{"name":"Glasgow Royal Infirmary Department of Cardiology, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alhussain","family":"Al Ajmi","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Alebraheem","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronnie","family":"Burns","sequence":"additional","affiliation":[{"name":"Parkhead Health Centre, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew P","family":"Davie","sequence":"additional","affiliation":[{"name":"Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Gan","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen J","family":"Hogg","sequence":"additional","affiliation":[{"name":"Glasgow Royal Infirmary Department of Cardiology, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colette E","family":"Jackson","sequence":"additional","affiliation":[{"name":"Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanouela","family":"Mathioudaki","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishika","family":"Pasupulate","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simran","family":"Piya","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lia","family":"Ritchie","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Simpson","sequence":"additional","affiliation":[{"name":"Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy C","family":"Steel","sequence":"additional","affiliation":[{"name":"Anniesland Medical Practice, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazel N","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John JV","family":"McMurray","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"},{"name":"Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark C","family":"Petrie","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"},{"name":"Glasgow Royal Infirmary Department of Cardiology, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0050-2129","authenticated-orcid":false,"given":"Ross T","family":"Campbell","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"},{"name":"Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"2026010906401720000_13.1.e003785.1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2022-321702"},{"key":"2026010906401720000_13.1.e003785.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.l223","article-title":"Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort 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SIGN 147 \u00b7 management of chronic heart failure. 2016. Available: https:\/\/www.sign.ac.uk\/assets\/sign147.pdf [Accessed 09 Jul 2025]."},{"key":"2026010906401720000_13.1.e003785.11","unstructured":"National Institute for Health and Care Excellence . Chronic heart failure in adults: diagnosis and management nice guideline [NG106]. 2018. 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