. 2024 Apr;11(2):672-680.

doi: 10.1002/ehf2.14625. Epub 2023 Dec 13.

The 'peptide for life' initiative in the emergency department study

Antoni Bayes-Genis¹, Gordana Krljanac², Marija Zdravković³, Milika Ašanin², Anastazija Stojšić-Milosavljević⁴, Slavica Radovanović⁵, Tamara Preradović Kovačević⁶, Aleksandar Selaković⁷, Ivan Milinković², Marija Polovina², Duška Glavaš⁸, Elizabeta Srbinovska^{9

10}, Nebojša Bulatović¹¹, Davor Miličić¹², Maja Čikeš¹², Zdravko Babić¹³, Jozica Šikić¹⁴, Zumreta Kušljugić¹⁵, Larisa Dizdarević Hudić¹⁵, Henrike Arfsten¹⁶, Laura M G Meems¹⁷, Marco Metra¹⁸, Giuseppe Rosano¹⁹, Petar M Seferović²⁰; Young Investigators of the Peptide for Life Initiative

Collaborators, Affiliations

Collaborators

Young Investigators of the Peptide for Life Initiative:
M Tomic, S Stankovic, M Klaric, M Viduljevic, N Djordjevic, J Klac, D Civric, T Pejovic, B Babic, T Nenezic, Z Radovanovic, B Jungic, A Milovancev, J Tripunovic, N Denda, I Milosavljevic, M Jankovic, B Dikovic, Z Zimbakov, I Mitevska, L Kostovski, V Popadic, A Radojevic, A Manojlovic, D Radovanovic, T Ivankovic, U Gajic, M Stojanovic, D Marinkovic, J Stojkovic, B Stojcic, V Savic, M Bogdanovic, M Sredojevic, N Blagojevic, M Radovanovic, L Tabakovic, J A Borovac, M Meter, M Parcina, A Sosic, M Ivanisevic Dzaja, J Katic, V Pasara, S Hoteit, Z Planinic

Affiliations

¹ Heart Institute, Hospital Universitari Germans Trias i Pujol, CIBERCV, Barcelona, Spain.
² Cardiology Clinic, University Medical Center, Medical Faculty University of Belgrade, Belgrade, Serbia.
³ Medical Faculty University of Belgrade, University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia.
⁴ Cardiology Clinic, Institute for Cardiovascular Diseases of Vojvodina, Medical Faculty University of Novi Sad, Novi Sad, Serbia.
⁵ Department of Cardiology, University Clinical Hospital Center 'Dr Dragisa Misovic-Dedinje', Belgrade, Serbia.
⁶ Clinic for Cardiovascular Diseases, University Clinical Centre of the Republic of Srpska, Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
⁷ Clinic for Internal Medicine, General Hospital Užice, Užice, Serbia.
⁸ Department of Cardiovascular Medicine, Clinical Hospital Center Split, University of Split Faculty of Medicine, Split, Croatia.
⁹ University Clinic of Cardiology, Skopje, Macedonia.
¹⁰ Medical Faculty, University 'Ss Cyril and Methodius', Skopje, Macedonia.
¹¹ Cardiology Clinic, Clinical Center Podgorica, School of Medicine University of Podgorica, Podgorica, Montenegro.
¹² University of Zagreb School of Medicine, Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia.
¹³ Clinic for Cardiovascular diseases, University Hospital Center Sestre milosrdnice, Zagreb, Croatia.
¹⁴ Department for Cardiovascular Diseases, School of Medicine, Clinical Hospital Center Sveti Duh, University of Zagreb, Zagreb, Croatia.
¹⁵ Medical School and University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.
¹⁶ Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
¹⁷ Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
¹⁸ Department of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili, University of Brescia, Brescia, Italy.
¹⁹ IRCCS San Raffaele Pisana, Rome, Italy.
²⁰ Medical Faculty University of Belgrade, Serbian Academy of Sciences and Arts, University Medical Center, Belgrade, Serbia.

PMID: 38093494
PMCID: PMC10966210
DOI: 10.1002/ehf2.14625

The 'peptide for life' initiative in the emergency department study

Antoni Bayes-Genis et al. ESC Heart Fail. 2024 Apr.

. 2024 Apr;11(2):672-680.

doi: 10.1002/ehf2.14625. Epub 2023 Dec 13.

Authors

Collaborators

Young Investigators of the Peptide for Life Initiative:
M Tomic, S Stankovic, M Klaric, M Viduljevic, N Djordjevic, J Klac, D Civric, T Pejovic, B Babic, T Nenezic, Z Radovanovic, B Jungic, A Milovancev, J Tripunovic, N Denda, I Milosavljevic, M Jankovic, B Dikovic, Z Zimbakov, I Mitevska, L Kostovski, V Popadic, A Radojevic, A Manojlovic, D Radovanovic, T Ivankovic, U Gajic, M Stojanovic, D Marinkovic, J Stojkovic, B Stojcic, V Savic, M Bogdanovic, M Sredojevic, N Blagojevic, M Radovanovic, L Tabakovic, J A Borovac, M Meter, M Parcina, A Sosic, M Ivanisevic Dzaja, J Katic, V Pasara, S Hoteit, Z Planinic

Affiliations

¹ Heart Institute, Hospital Universitari Germans Trias i Pujol, CIBERCV, Barcelona, Spain.
² Cardiology Clinic, University Medical Center, Medical Faculty University of Belgrade, Belgrade, Serbia.
³ Medical Faculty University of Belgrade, University Clinical Hospital Center Bezanijska kosa, Belgrade, Serbia.
⁴ Cardiology Clinic, Institute for Cardiovascular Diseases of Vojvodina, Medical Faculty University of Novi Sad, Novi Sad, Serbia.
⁵ Department of Cardiology, University Clinical Hospital Center 'Dr Dragisa Misovic-Dedinje', Belgrade, Serbia.
⁶ Clinic for Cardiovascular Diseases, University Clinical Centre of the Republic of Srpska, Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
⁷ Clinic for Internal Medicine, General Hospital Užice, Užice, Serbia.
⁸ Department of Cardiovascular Medicine, Clinical Hospital Center Split, University of Split Faculty of Medicine, Split, Croatia.
⁹ University Clinic of Cardiology, Skopje, Macedonia.
¹⁰ Medical Faculty, University 'Ss Cyril and Methodius', Skopje, Macedonia.
¹¹ Cardiology Clinic, Clinical Center Podgorica, School of Medicine University of Podgorica, Podgorica, Montenegro.
¹² University of Zagreb School of Medicine, Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia.
¹³ Clinic for Cardiovascular diseases, University Hospital Center Sestre milosrdnice, Zagreb, Croatia.
¹⁴ Department for Cardiovascular Diseases, School of Medicine, Clinical Hospital Center Sveti Duh, University of Zagreb, Zagreb, Croatia.
¹⁵ Medical School and University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.
¹⁶ Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
¹⁷ Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
¹⁸ Department of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili, University of Brescia, Brescia, Italy.
¹⁹ IRCCS San Raffaele Pisana, Rome, Italy.
²⁰ Medical Faculty University of Belgrade, Serbian Academy of Sciences and Arts, University Medical Center, Belgrade, Serbia.

PMID: 38093494
PMCID: PMC10966210
DOI: 10.1002/ehf2.14625

Abstract

Aims: Natriuretic peptide (NP) uptake varies in Emergency Departments (EDs) across Europe. The 'Peptide for Life' (P4L) initiative, led by Heart Failure Association, aims to enhance NP utilization for early diagnosis of heart failure (HF). We tested the hypothesis that implementing an educational campaign in Western Balkan countries would significantly increase NP adoption rates in the ED.

Methods and results: This registry examined NP adoption before and after implementing the P4L-ED study across 10 centres in five countries: Bosnia and Herzegovina, Croatia, Montenegro, North Macedonia, and Serbia. A train-the-trainer programme was implemented to enhance awareness of NP testing in the ED, and centres without access received point-of-care instruments. Differences in NP testing between the pre-P4L-ED and post-P4L-ED phases were evaluated. A total of 2519 patients were enrolled in the study: 1224 (48.6%) in the pre-P4L-ED phase and 1295 (51.4%) in the post-P4L-ED phase. NP testing was performed in the ED on 684 patients (55.9%) during the pre-P4L-ED phase and on 1039 patients (80.3%) during the post-P4L-ED phase, indicating a significant absolute difference of 24.4% (95% CI: 20.8% to 27.9%, P < 0.001). The use of both NPs and echocardiography significantly increased from 37.7% in the pre-P4L-ED phase to 61.3% in the post-P4L-ED phase. There was an increased prescription of diuretics and SGLT2 inhibitors during the post-P4L-ED phase.

Conclusions: By increasing awareness and providing resources, the utilization of NPs increased in the ED, leading to improved diagnostic accuracy and enhanced patient care.

Keywords: Access; Adoption; Awareness; Emergency department; Natriuretic peptides; Peptide for life.

PubMed Disclaimer

Conflict of interest statement

AB‐G has lectured and/or participated in advisory boards for Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, Roche Diagnostics, and Vifor.

AB‐G reports personal fees or advisory boards from Abbott, AstraZeneca, Boehringer Ingelheim, Bayer, Novartis, NovoNordisk, Roche Diagnostics and Vifor Pharma. The rest ofthe authors declare no conflict of interest.

Figures

**Figure 1**
Distribution of natriuretic peptides concentrations in relation to cut‐points. BNP, B‐type natriuretic peptide; NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.

**Figure 2**
Heart failure diagnostics pathways pre and post P4L‐ED implementation. Echocardio, echocardiography; ED, emergency department; NPs, natriuretic peptides.

**Figure 3**
Distribution of Natriuretic Peptides according to cut‐points and final diagnosis.

See this image and copyright information in PMC

References

1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2022;24:4‐131. doi:10.1002/ejhf.2333 - DOI - PubMed
1. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive summary: A report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. J Am Coll Cardiol 2022;79:1757‐1780. doi:10.1016/j.jacc.2021.12.011 - DOI - PubMed
1. Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail 2021;23:352‐380. doi:10.1002/ejhf.2115 - DOI - PubMed
1. Seferović PM, Vardas P, Jankowska EA, Maggioni AP, Timmis A, Milinković I, et al. National Heart Failure Societies of the ESC member countries (see appendix). The heart failure association atlas: heart failure epidemiology and management statistics 2019. Eur J Heart Fail 2021;23:906‐914. doi:10.1002/ejhf.2143 - DOI - PubMed
1. Bayes‐Genis A, Januzzi JL, Richards AM, Arfsten H, de Boer RA, Emdin M, et al. The ‘Peptide for Life’ initiative: A call for action to provide equal access to the use of natriuretic peptides in the diagnosis of acute heart failure across Europe. Eur J Heart Fail 2021;23:1432‐1436. doi:10.1002/ejhf.2293 Epub 2021 Jul 16. PMID: 34231321 - DOI - PubMed

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The 'peptide for life' initiative in the emergency department study

Collaborators

Affiliations

The 'peptide for life' initiative in the emergency department study

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Substances

LinkOut - more resources

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Medical

Research Materials

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