Patients with brain-type natriuretic peptide (BNP) levels of 50pg/mL or higher who were given specialist care to manage risk factors had a lower rate of left ventricular dysfunction and heart failure after four years than those on standard care.
Researchers said targeted BNP screening campaigns to prevent heart failure could cut emergency cardiovascular admissions.
The study was published in the journal JAMA.
NICE currently advises GPs to use BNP testing to rule out heart failure and to avoid the need for referral or further costly tests. It is also used by secondary care as a diagnostic tool.
The RCT by St. Vincent's Healthcare Group and St. Michael's Hospital in Dublin assigned 1,374 middle aged patients in Ireland to BNP screening or standard care.
Patients with BNP levels over 50pg/mL had an ECG taken and were followed up by specialist cardiovascular services. This included support from a specialist nurse, who emphasised to patients the importance of medicines adherence and healthy lifestyle.
The tests found 263 patients (42%) had raised BNP levels.
After four years, 5.2% of screened patients had developed ventricular dysfunction or heart failure, compared with 8.7% of the control group. Asymptomatic left ventricular dysfunction was detected in 4.3% of screened patients and 6.6% of control group patients.
Similarly, fewer patients were admitted to hospital with a major adverse cardiovascular event in the screening group than the control group.
Authors said the intervention led to better control of risk factors and greater use of treatments to target patients at risk of heart failure.