Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry

Επιστημονική δημοσίευση - Άρθρο Περιοδικού uoadl:3105897 82 Αναγνώσεις

Μονάδα:
Ερευνητικό υλικό ΕΚΠΑ
Τίτλος:
Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Methods and results: Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). Conclusion: These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology
Έτος δημοσίευσης:
2019
Συγγραφείς:
Komajda, M.
Schöpe, J.
Wagenpfeil, S.
Tavazzi, L.
Böhm, M.
Ponikowski, P.
Anker, S.D.
Filippatos, G.S.
Cowie, M.R.
Aleksanyan, A.
Atayan, L.
Avetisyan, A.
Davtyan, N.
Drambyan, M.
Gevorgyan, K.
Grigoryan, M.
Hakobyan, Z.
Hayrapetyan, H.
Kocharyan, L.
Kramarevskaya, T.
Melqonyan, A.
Muradyan, F.
Nanyan, R.
Ordyan, A.
Ordyan, M.
Piruzyan, A.
Podosyan, G.
Safaryan, K.
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Bou-Samra, J.
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Ho, B.
Hopper, I.
Jackson, B.
Korczyk, D.
Lattimore, J.D.
Levendel, A.
Macfadyen, R.
Pandeli, V.
Playford, D.
Richardson, M.
Senior, J.A.
Shah, A.
Shetty, P.
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Srivastava, P.
Swale, M.
Vogl, E.
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William, M.
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Tarlovskaya, E.
Temnikova, E.
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Tolstov, S.
Uskatch, T.
Ustyuzhanin, V.
Valeeva, R.
Vasyuk, Y.
Viktorova, I.
Yakushin, S.
Zadionchenko, V.
Zateischikov, D.
Zhirov, I.
Bollová, D.
Dulková, K.
Fazekaš, F.
Hermel, I.
KŇazeje, M.
NedĚĽová, I.
Nociar, J.
Procházka, L.
Pundová, L.
Slanina, M.
Varga, I.
Almenar, L.
Beltrán, P.
Cobo, M.
Delgado, J.
Enjuanes, C.
Garrido, I.
Gómez, M.A.
Manito, N.
Marzal, D.
Murga, N.
Ocampo, M.
Pérez, J.
Sánchez, I.
Buakhamsri, A.
Leemasawat, K.
Kanoksilp, A.
Kiatchoosakun, S.
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Porapakkham, P.
Rodprasert, S.
Senthong, V.
Wongcharoen, W.
Wongwantanee, S.
Bahadir, H.
Emül, A.
Gokce, M.
Gurcagan, A.
Kaya, O.K.
Keser, A.
Pinar, P.
Taș, M.H.
Tosun, H.B.
Yazlar, A.S.
Yilmaz, S.
Yuksel, Y.
Bagriy, A.
Ivchyna, N.
Lyashenko, A.
Matviychuk, N.
Shchukina, O.
Tkach, N.
Tseluyko, V.
Vasylieva, L.
Abdallah, A.
Agrawal, A.
Basleeb, F.
Bazargani, N.
Hatou, E.
Al Kaddour, A.R.
Al Kasser, M.
Al Mulla, A.
Radaideh, G.
Salustri, A.
on behalf of the QUALIFY Investigators
Περιοδικό:
European Journal of Heart Failure
Εκδότης:
John Wiley and Sons Ltd
Τόμος:
21
Αριθμός / τεύχος:
7
Σελίδες:
921-929
Λέξεις-κλειδιά:
angiotensin receptor antagonist; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor; ivabradine; mineralocorticoid antagonist; cardiovascular agent, adult; Article; cardiovascular mortality; female; heart failure with reduced ejection fraction; hospitalization; human; longitudinal study; major clinical study; male; New York Heart Association class; observational study; outpatient care; priority journal; prospective study; protocol compliance; classification; clinical practice; follow up; heart failure; heart stroke volume; medication therapy management; middle aged; mortality; outpatient; pathophysiology; practice guideline; protocol compliance; register; total quality management, Cardiovascular Agents; Female; Follow-Up Studies; Guideline Adherence; Heart Failure; Hospitalization; Humans; Male; Medication Therapy Management; Middle Aged; Outcome Assessment, Health Care; Outpatients; Practice Guidelines as Topic; Practice Patterns, Physicians'; Quality Improvement; Registries; Stroke Volume
Επίσημο URL (Εκδότης):
DOI:
10.1002/ejhf.1459
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