We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byBrandon Riley
Modified over 3 years ago
© 2010, American Heart Association. All rights reserved. Evolving Patterns of Use and Appropriateness of Aldosterone Antagonists in Heart Failure Nancy M. Albert, PhD, RN; Clyde W. Yancy, MD; Li Liang, PhD; Adrian F. Hernandez, MD; Eric D. Peterson, MD, MPH, Xin Zhao, MS, Christopher P. Cannon, MD; Gregg C. Fonarow, MD Albert et al. JAMA. 2009;302(15):1658-1665.
© 2010, American Heart Association. All rights reserved. Background Aldosterone antagonists are recommended in patients with moderate-to-severe heart failure (HF) and systolic dysfunction. Prior studies suggest underutilization of aldosterone antagonists in eligible patients as well as overuse in settings where therapy may be harmful. Albert et al. JAMA. 2009;302(15):1658-1665.
© 2010, American Heart Association. All rights reserved. Introduction Data support the use of aldosterone antagonists in heart failure patients. Aldosterone antagonists are underutilized in eligible patients. The GWTG Program has been shown to improve the appropriate use of aldosterone antagonist therapy in heart failure patients. Albert et al. JAMA. 2009;302(15):1658-1665.
© 2010, American Heart Association. All rights reserved. Objective The purpose of the paper was to evaluate whether a hospital-based quality program such as GWTG improves the use of aldosterone antagonist therapy in the appropriate patient population. Albert et al. JAMA. 2009;302(15):1658-1665.
© 2010, American Heart Association. All rights reserved. Methods Observational analysisObservational analysis Outcome measures were prescription and predictors of use of aldosterone antagonists, based on guideline criteria.Outcome measures were prescription and predictors of use of aldosterone antagonists, based on guideline criteria. 43,625 patients admitted with HF and discharged home from 241 hospitals participating in the Get With The Guidelines--HF quality improvement registry between 2005-2007.43,625 patients admitted with HF and discharged home from 241 hospitals participating in the Get With The Guidelines--HF quality improvement registry between 2005-2007. Albert et al. JAMA. 2009;302(15):1658-1665.
© 2010, American Heart Association. All rights reserved. Results Rates of inappropriate use of aldosterone antagonists are low: 0.5% use in patients with documented contraindications and 2.7% use in patients with higher than recommended creatine levels. The data suggest that less than one third of eligible HF patients were prescribed an aldosterone antagonist. Only 32.5% (4,087 out of 12,565) of eligible HF patients were prescribed aldosterone antagonist therapy at discharge. Over the study period, the number of eligible HF patients receiving an aldosterone antagonist increased from 28% to 34%. The data showed that the following patient populations received aldosterone antagonist at a higher rate: young patients, African Americans, those with lower systolic blood pressures, a history of implantable cardioverter-defibrillator use, depression, alcohol use, and pacemaker implantation, and those with no history of renal insufficiency. Increases in aldosterone antagonist usage in eligible patients were small from 2005-2007 and stayed below 35% while inappropriate aldosterone antagonist use remained low. Albert et al. JAMA. 2009;302(15):1658-1665. Albert JAMA 2009
© 2010, American Heart Association. All rights reserved. Conclusions These data suggest that in the context of a hospital- based performance improvement program, aldosterone antagonist therapy can be used according to guidelines with little inappropriate use. Given the substantial morbidity and mortality risk faced by patients hospitalized with HF and the established efficacy of aldosterone antagonist use in HF, a stronger uptake of aldosterone antagonist therapy indicated by evidence-based guidelines may be warranted. Albert et al. JAMA. 2009;302(15):1658-1665.
Treatment and Risk in Heart Failure: Gaps in Evidence or Quality? Pamela N. Peterson, MD MSPH; John S. Rumsfeld, MD PhD; Li Liang PhD; Adrian F. Hernandez,
© 2010, American Heart Association. All rights reserved. A Validated Risk Score for In-hospital Mortality in Patients with Heart Failure from the American.
“Influence of age on the management of heart failure: Findings from Get With the Guidelines–Heart Failure (GWTG-HF)” Daniel E. Forman, MD; Christopher.
Hernandez et al. JAMA, May 5, 2010 – Vol. 303, No. 17 Relationship Between Early Physician Follow-up and 30-day Readmission Among Medicare Beneficiaries.
Clinical Effectiveness of Implantable Cardioverter-Defibrillators Among Medicare Beneficiaries With Heart Failure Adrian F. Hernandez, MD, MHS; Gregg.
© 2010, American Heart Association. All rights Association of Hospital Primary Angioplasty Volume in ST-Segment Elevation Myocardial Infarction With Quality.
© 2010, American Heart Association. All rights reserved. Are Quality Improvements Associated with the GWTG-Coronary Artery Disease (GWTG-CAD) Program Sustained.
Schwamm et al. Circulation epub April 6Schwamm et al. Race/Ethnicity, Quality of Care, and Outcomes in Ischemic Stroke Lee H. Schwamm, MD; Mathew.
Trends in the Use of Evidence-Based Treatments for Coronary Artery Disease Among Women and the Elderly Findings From the Get With the Guidelines Quality-
Quality of Care and In-Hospital Outcomes in Patients With Coronary Heart Disease in Rural and Urban Hospitals (from Get With the Guidelines– Coronary.
“ Age-Related Differences in Characteristics, Performance Measures, Treatment Trends, and Outcomes in Patients with Ischemic Stroke ” Gregg C. Fonarow,
Regional Differences in Quality of Care and Outcomes for the Treatment of Acute Coronary Syndromes: An Analysis from the Get With The Guidelines Program.
Are Quality Improvements Associated with the GWTG-Coronary Artery Disease (GWTG-CAD) Program Sustained Over Time? A Longitudinal Comparison of GWTG-CAD.
“Influence of Stroke Subtype on Quality of Care in The Get With The Guidelines-Stroke Program” Eric E. Smith, MD, MPH; Li Liang PhD; Adrian F Hernandez,
Evolving Patterns Of Use Of Aldosterone Inhibition In Chronic Heart Failure; A Report From Get With The Guidelines HF Nancy M. Albert, Clyde W. Yancy,
Influence of Age on the Management of Heart Failure: Findings from Get With the Guidelines-HF DE Forman, CP Cannon, AF Hernandez, L Liang, CW Yancy, GC.
Improving Evidence-Based Care for Heart Failure in Outpatient Cardiology Practices: Primary Results of the Registry to Improve Heart Failure Therapies.
The Relationship Between CMS Quality Indicators and Long-term Outcomes Among Hospitalized Heart Failure Patients Mark Patterson, Ph.D., M.P.H. Post-doctoral.
” “The Dissociation Between Door-to- Balloon Time Improvement and Improvements in Other Acute Myocardial Infarction Care Processes and Patient Outcomes”
Use of Hydralazine-Isosorbide Dinitrate combination in African American and Other Race/Ethnic Group Patients with Heart Failure and Reduced Ejection Fraction.
© 2010, American Heart Association. All rights reserved. Hospital Performance Recognition with the Get with the Guidelines Program and Mortality for Acute.
Associations Between Outpatient Heart Failure Process of Care Measures and Mortality Gregg C. Fonarow, Nancy M. Albert, Anne B. Curtis, Mihai Gheorghiade,
Risks of Intracranial Hemorrhage among Patients with Acute Ischemic Stroke Receiving Warfarin and Treated with Intravenous Tissue Plasminogen Activator.
Predictors of Cardiac Rehabilitation Referral in Coronary Artery Disease Patients: Results From the AHA’s Get With the Guidelines Program Todd M. Brown,
Natale MARRAZZO Francesco SOLIMENE Quando la CRT-P può bastare?
Connie N. Hess, MD, Bimal R. Shah, MD, MBA, S. Andrew Peng, MS, Laine Thomas, PhD, Matthew T. Roe, MD, MHS, Eric D. Peterson, MD, MPH Relationship of Early.
Fonarow GC, et al. J Am Coll Cardiol. 2007;50:768 777. Characteristics, Treatments, and Outcomes of Patients With Preserved Systolic Function Hospitalized.
“Hospital Performance Recognition with the Get with the Guidelines Program and Mortality for Acute Myocardial Infarction and Heart Failure Paul A Heidenreich,
May 2005 EP Show The EP Show COMPANION and CARE-HF Eric Prystowsky MD Director, Clinical Electrophysiology Laboratory St Vincent Hospital Indianapolis,
Saver et al. Epub June 3, 2010 STROKE The Golden Hour and Acute Brain Ischemia: Presenting Features and Lytic Therapy in Over 30,000 Patients Arriving.
EP Testing and Use of Devices in Heart Failure HFSA 2010 Recommendations.
Admission B-Type Natriuretic Peptide Levels and In-Hospital Mortality in Acute Decompensated Heart Failure Fonarow GC et al. J Am Coll Cardiol 2007; 49(19):
Date of download: 9/18/2016 Copyright © The American College of Cardiology. All rights reserved. From: Presidential address: quality of cardiovascular.
Patients with HF have increased risk for thrombotic events. However, the net clinical benefit of anticoagulation in a HF population in sinus rhythm has.
Effect of Rapid Clinic Follow-Up After Hospital Discharge on 30- Day Heart Failure Readmission Lee Arcement, MD, MPH Dragana Lovre, MD.
Acute Myocardial Infarction (Heart Attack) Committee Membership: B. Majcher, APRN, C. Mulhall, APRN, K. McLean, MD, M. Jarotkiewicz RRT, MS, Administrative.
Which Beta-Blocker is Best for Patients with Heart Failure? Summary and Comment by Joel M. Gore, MD Published in Journal Watch Cardiology December 17,
Lessons Learned through Research: Do Hospitals and Ambulatory Centers Follow Guideline Recommended Care Nancy Albert, PhD, RN, CCNS, CCRN, NE-BC, FAHA,
S. HUNT Tenth International Symposium HEART FAILURE & Co. CARDIOLOGY SCIENCE UPDATE FEMALE DOCTORS SPEAKING ON FEMALE DISEASES Milano aprile 2010.
Implantable Cardioverter Defibrillators to Prevent Sudden Cardiac Death: Background Frederick A. Masoudi, MD, MSPH Associate Professor of Medicine (Cardiology)
Clinical Trial Results. org Characteristics, Management, and Outcomes of 5,557 Patients Age ≥90 Years With Acute Coronary Syndromes: Results From the CRUSADE.
Stroke Quality Measures Kathy Wonderly RN, BSPA, CPHQ Performance Improvement Coordinator Developed: May, 2012 Most recently updated: October,
Ridha Chakeer MD PGY3. Objectives: Approximately 5.2 million Americans are affected accounts for more than 3 million outpatient visits to primary care.
10.5% 9.7% 8.2% 6.4% 11.9% 53.3% Hospitalization $20.9 Lost Productivity/ Mortality* $4.1 Home Healthcare $3.8 Drugs/Other Medical Durables $3.2 Physicians/Other.
Dr M. Abubakr Shaikh The Aga Khan University Hospital, Karachi HEART FAILURE GUIDELINES: A COMPARISON.
Yancy et al. J Am Coll Cardiol. 2008;51:1675 84. Quality of Care of and Outcomes for African Americans Hospitalized With Heart Failure: Findings From.
Inder Anand, MD, FRCP, D Phil (Oxon.) Professor of Medicine, University of Minnesota, Director Heart Failure Program, VA Medical Center 111C Minneapolis,
Date of download: 6/26/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Effectiveness of CRT and ICD Therapy in.
Acknowledgements Contact Information Anthony Wong, MTech 1, Senthil K. Nachimuthu, MD 1, Peter J. Haug, MD 1,2 Patterns and Rules Vital signs medoids.
© 2017 SlidePlayer.com Inc. All rights reserved.