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Treatment performance measures affect clinical outcomes in patients with acute systolic heart failure: report from the Korean Heart Failure Registry.

 Young Jin Youn  ;  Byung-Su Yoo  ;  Jun-Won Lee  ;  Jang-Young Kim  ;  Seong Woo Han  ;  Eun-Seok Jeon  ;  Myeong-Chan Cho  ;  Jae-Joong Kim  ;  Seok-Min Kang  ;  Shung Chull Chae  ;  Byung-Hee Oh  ;  Dong-Ju Choi  ;  Myung Mook Lee  ;  Kyu-Hyung Ryu 
 CIRCULATION JOURNAL, Vol.76(5) : 1151-1158, 2012 
Journal Title
Issue Date
Acute Disease ; Adrenergic beta-Antagonists/therapeutic use ; Advance Directive Adherence ; Aged ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Disease-Free Survival ; Female ; Follow-Up Studies ; Heart Failure, Systolic/mortality* ; Heart Failure, Systolic/therapy* ; Humans ; Male ; Middle Aged ; Registries* ; Republic of Korea/epidemiology ; Survival Rate ; Task Performance and Analysis ; Substances
Left ventricular systolic dysfunction ; Mortality ; Performance measures
BACKGROUND: There is a paucity of data on the effects of adherence to treatment on outcomes for patients with acute heart failure (HF) in Korea. We used HF performance measures to evaluate overall adherence and whether this affects clinical outcomes.

METHODS AND RESULTS: Among 3,466 patients in the Korean Heart Failure Registry, 1,527 patients with left ventricular systolic dysfunction (LVSD) who survived hospitalization were evaluated. Modified validated performance measures were defined as follows: use at discharge of angiotensin-converting enzyme inhibitor (ACEI), angiotensin-receptor II blocker (ARB), β-blocker or aldosterone receptor antagonist. Adherence to performance measures were as follows: ACEI or ARB at discharge, 68.0%; β-blocker at discharge, 40.9%; aldosterone receptor antagonist at discharge, 37.5%. On multivariate analysis, adherence to the measure of ACEI or ARB use at discharge was significantly associated with mortality (odds ratio (OR), 0.344; 95% confidence interval (CI), 0.123-0.964), readmission (OR, 0.180; 95%CI, 0.062-0.522) and mortality/readmission (OR, 0.297; 95%CI, 0.125-0.707) at 60 days and that for β-blocker with mortality (OR, 0.337; 95%CI, 0.147-0.774) at 1 year.

CONCLUSIONS: For patients with LVSD in Korea, adherence to treatment performance measures, including prescription of an ACEI/ARB and β-blocker use at discharge, is associated with improved clinical outcomes.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
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