October 21, 2009

Many Heart Failure Patients Do Not Get Proper Drug Treatments

Less than one-third of heart failure patients leave the hospital with drugs recommended for their condition, researchers reported Tuesday.

Researchers studied 43,625 patients admitted to 241 hospitals with heart failure and discharged home.

Researchers found that 12,565 patients (28.8 percent) from 201 hospitals met American College of Cardiology/American Heart Association Chronic HF Guidelines for aldosterone antagonists treatment, which involves an agent that opposes the action of the adrenal hormone aldosterone.

Treatment increased from 28 percent to 34 percent during the study period, researchers noted.

The study shows that adherence to the ACC/AHA guidelines among hospitals have been mixed.

"The Get With The Guidelines"“HF (GWTG-HF) program is a national quality improvement program designed to promote adherence to guideline-based recommendations. It is unknown whether participation in a hospital-based quality program may lead to greater frequency of use of aldosterone antagonist therapy for appropriate indications as well as lower use in situations of increased risk," the authors write in the Journal of the American Medical Association.

"Aldosterone antagonist use in eligible patients was associated with younger age, African American race/ethnicity, lower systolic blood pressure, history of implantable cardioverter-defibrillator use, depression, alcohol use, and pacemaker implantation, and with having no history of renal insufficiency," they noted.

"These data confirm 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 prescription in HF, a stronger uptake of aldosterone antagonist therapy indicated by evidence-based guidelines may be warranted."


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