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A new £3m research programme funded by an National Institute for Health Research Programme Grant for Applied Research (PGfAR) will investigate screening to detect undiagnosed atrial fibrillation, a heart condition responsible for one in ten strokes.

Pgfar
At the moment, atrial fibrillation is detected haphazardly in some practices by opportunistic case finding. Our NIHR programme of research is testing a way of systematically screening everybody over 65 for atrial fibrillation. It’s more complete than the existing approach and simple, so won’t take up much doctor or nurse time.”
- Professor Jonathan Mant, Cambridge University

With the School's Cambridge lead Professor Mant at the helm and the School's Director Professor Richard Hobbs as co-applicant, the study aims to find out if screening for atrial fibrillation in people aged 65 and over can prevent stroke and other problems that cause early deaths like heart attacks, and whether screening represents good value for money for the NHS.

The research will involve 120,000 patients aged over 65 in 300 general practices across England. Patients in 100 practices will undergo screening, and those in 200 practices will not. If screening detects a case of atrial fibrillation, the patient will be offered treatment such as anticoagulant drugs to reduce their risk of stroke and heart attack. Both sets of patients will be followed up for five years to see whether screening and treatment leads to fewer strokes, heart attacks and deaths.Read the full press release.

Both Professors Mant and Hobbs were involved in earlier School funded studies that significantly added to the current evidence on stroke prevention strategies, projects that were instrumental in leveraging this further funding from the NIHR. One of these resulted in the following publication: Would primary healthcare professionals prescribe a polypill to manage cardiovascular risk? A qualitative interview study. Satnam K VirdeeSheila M Greenfield, Kate Fletcher, Richard J McManusF D Richard HobbsJonathan Mant.

Additional related projects supported by the school:

  • Prevention of stroke 1: Improving diagnosis and management of stroke and TIA (OXVASC)
  • Echocardiographic Heart of England Screening Extension Study (ECHOES-X): The incidence and progression of heart failure, left systolic ventricular dysfunction and borderline systolic dysfunction and prospective BNP screening sub-study
  • The REFER (REFer for EchocaRdiogram) Study:  Clinical Decision Rule and NT-proBNP in the Diagnosis of Heart Failure: Prospective Validation
  • Improving adherence to antihypertensive mediations: a behavioural intervention delivered by pharmacists
  • Improving outcomes for stroke survivors in the community and in care homes:  adherence to guidance in primary care
  • TIA DELAY – A qualitative study of patients’ healthcare seeking behaviours after transient ischaemic attack and minor stroke
  • Assessing the value of the novel biomarker copeptin in the identification of older people at high risk of heart failure in the primary care setting