title: Treatment performance measures affect clinical outcomes in patients with acute systolic heart failure: report from the Korean Heart Failure Registry.
abstract: 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.
  
  
  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.
authors.affiliation: Division of Cardiology, Yonsei University Wonju Christian Hospital, Wonju, South Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Youn
authors.forename: Byung-Su
authors.initials: BS
authors.lastname: Yoo
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Jang-Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Han
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Jeon
authors.forename: Myeong-Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Byung-Hee
authors.initials: BH
authors.lastname: Oh
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.forename: Myung Mook
authors.initials: MM
authors.lastname: Lee
authors.forename: Kyu-Hyung
authors.initials: KH
authors.lastname: Ryu
mesh_terms: D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D024362:Advance Directive Adherence; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D054143:Heart Failure, Systolic / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate; D013647:Task Performance and Analysis
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors