STOP-HF Investigators St. Vincent’s / St. Michael’s Hospitals and Collaborative GP Group Dublin, Ireland The Saint Vincents Screening To Prevent Heart Failure (STOP-HF) Study HF

Heartbeat Trust Major Goals: – Developing new methods of heart care in the community – Advocating for the implementation of new methods – Facilitating provision of services Aligned to St Vincent’s / St Michaels’s Hospitals

This evening… 1.What is new for the STOP-HF programme for 2015 – Prof Ken McDonald 2.The STOP-HF programme, what diet & how to care for yourself - Elaine Tallon, STOP-HF Nurse 3.Keeping your body fit & strong - Karen Cradock, specialist physiotherapist 4.Fundraising Initiatives 2015; Get involved! –Katie Reilly, Heartbeat Trust 5.Questions & Discussion – Prof Ken McDonald, Dr Joe Gallagher, Elaine Tallon, Karen Cradock

Where the Present System Works; The Once-Off encounter

Where the System Fails; Chronic, extended, multi-level care

Modern Day Prevention in Heart Medicine  High Blood Pressure  Diabetes Mellitus  Cigarette Smoking  High Cholesterol  Family History  Obesity / Sedentary Lifestyle  Exposure to heart toxins  Chemotherapy  Alcohol

40yrs 60yrs 80yrs QoL and Costs Quality of Life at present Multiple Risk Factors Heart Attack. Heart Failure Our Journey in Cardiovascular Disease

40yrs 60yrs 80yrs QoL and Costs Quality of Life at present Aspirational QoL Multiple Risk Factors M.I. HF and CV admissions The Patient Journey in Cardiovascular Disease

Predict, Protect, Prevent  ~800,000 with high blood pressure  300,000 diabetics  Valve disease  Survivors of heart attack  Survivors of cancer treatment ~1,000,000 people at-risk;

BNP Blood Test; Predict, Protect, Prevent  Protein made by the heart when aware of something going wrong  An early response  Gives signal before standard tests  Helps pick out higher risk status  Allows focus of care on this group

 Natriuretic peptide screening  Targeted collaborative care  At-risk population  Decrease LVD and HF Predict, Protect, Prevent The STOP-HF Trial

STOP-HF Intervention N=677N=697

Main outcome Routine Care

Other outcomes But even more noticeable impact on other heart and blood vessel conditions – Reduction in frequency of other heart conditions requiring hospital by ~50% 4.5% per annum to 2.2% – Mainly Stroke, Threatened Stroke, Heart Rhythm Irregularity

STOP-HF Conclusion Natriuretic peptide-based screening and collaborative care targeted 4 in 10 at-risk patients Reduced the rates heart failure, and emergency hospitalizations for major cardiovascular events.

Next Step wIth STOP-HF STOP-HF Clinical Service  Now part of SVUH cardiology  Funded by HBT  Exciting developments to minimise travel Further Research  New Treatments  Next generation Marker ( New NP!)  Funded by Grants

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