title: Association between conformity with performance measures and 1-year postdischarge survival in patients with acute decompensated heart failure.
abstract: Recognition of the treatment gap in patients with heart failure (HF) led to the development of a set of process-of-care measures to improve the quality of care. To assess the association of established and emerging process-of-care measures with 1-year postdischarge survival, 496 patients with acute decompensated HF were studied. After adjustment for established prognostic factors, the relative risk (RR) for mortality in patients eligible for treatment was as follows: 0.49 (P < .001) for discharge prescription of renin-angiotensin system inhibitors (RAS-Is), 0.59 (P = .015) for β-blockers, 0.44 (P < .001) for combination therapy (ie, a β-blocker and a RAS-I), 0.87 (P nonsignificant) for aldosterone antagonists, and 0.49 (P nonsignificant) for planned cardioverter-defibrillator implantation. After adjustment for propensity scores, the RR was 0.49 (P < .001) for RAS-Is, 0.67 (P = .04) for β-blockers, and 0.57 (P < .001) for combination therapy. The data suggest that performance measures for RAS-Is, β-blockers, and combination therapy are strongly associated with improved 1-year survival.
authors: Division of Cardiology and Cardiac Rehabilitation, Fondazione S Maugeri, IRCCS, Istituto di Cassanodelle Murge, Cassano Murge, Bari, Italy. domenico.scrutinio@fsm.it
authors: Domenico
authors: D
authors: Scrutinio
authors: Andrea
authors: A
authors: Passantino
authors: Vito Antonio
authors: VA
authors: Ricci
authors: Raffaella
authors: R
authors: Catanzaro
mesh_terms: D000208:Acute Disease; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015897:Comorbidity; D017147:Defibrillators, Implantable; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D012189:Retrospective Studies
chemical_list: D002317:Cardiovascular Agents