Grant: Travel Awards - Institute Community Support

People with acute heart problems often present to the emergency department. Some of these people have heart failure, where the heart cannot pump sufficient blood for the rest of the body to function. Heart failure is a challenging disease with a high burden for health systems. It is very important to diagnose as early as possible, to slow, stop or reverse the disease progress. Biomarkers are the mainstays in the early diagnosis of diseases. Natriuretic peptide, biomarkers that can be tested through blood samples, have been applied recently for the diagnosis and prognostication of patients suspected to have heart failure. In 2007, BNP testing was made available to Greater Edmonton's Emergency departments, and access to this test has been extended, subsequently, to the rest of Alberta. In this study we aim to study the NP testing uptake in Alberta, to see the difference between patients with and without heart failure who have or have not been tested for NPs. For this aim, we will use the population data, i.e. the databases which are developed and maintained by Alberta Health Services. Several groups so far have investigated whether these biomarkers could be used to guide our HF treatment, i.e. to titrate the dosage and type of medications according to the blood level of these tests. The efficacy of this approach is still controversial. We have decided to lump all studies (by meta-analysis) to provide the most-informed answer. In another part of this study we want to address a very routine therapy that is used commonly in heart failure patients, i.e. oxygen therapy. Scientific information so far has shown no benefit for this treatment, and possibly, that extra oxygen can be harmful to patients. We propose a trial where we study the effects of extra (high) versus lower (low) oxygen levels using a special little device that can monitor and give extra oxygen if needed, and we can set the levels. The feasibility of doing a large trial will be tested using a pilot project.