SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR)

A multi-center, retrospective, observational study

Byungsu Yoo, Jaewon Oh, Bum Kee Hong, Dae Hee Shin, Jang Ho Bae, Dong Heon Yang, Wan Joo Shim, Hyung Seop Kim, Su Hong Kim, Jin Oh Choi, Woo Jung Chun, Choong Won Go, Hyun Jae Kang, Sang Hong Baek, Jang Hyun Cho, Suk Keun Hong, Joon Han Shin, Seok Kyu Oh, Wook Bum Pyun, Jun Kwan & 4 others Young Joon Hong, Jin Ok Jeong, seokmin kang, Dong Ju Choi

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea. Method and Results: The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45%) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50%) and poor guideline adherence (GAI <50%). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7%; BB, 69.2%; and AA, 65.9%. Overall, 82.7% of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2% and 37.4%, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups. Conclusions: Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.

Original languageEnglish
Article numbere86596
JournalPloS one
Volume9
Issue number1
DOIs
Publication statusPublished - 2014 Jan 27

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Systolic Heart Failure
Guideline Adherence
observational studies
heart failure
Observational Studies
Retrospective Studies
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Mineralocorticoid Receptor Antagonists
beta-adrenergic antagonists
angiotensins
Guidelines
Therapeutics
Korea
aldosterone
Hospitalization
receptors
Korean Peninsula
Mortality
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Yoo, Byungsu ; Oh, Jaewon ; Hong, Bum Kee ; Shin, Dae Hee ; Bae, Jang Ho ; Yang, Dong Heon ; Shim, Wan Joo ; Kim, Hyung Seop ; Kim, Su Hong ; Choi, Jin Oh ; Chun, Woo Jung ; Go, Choong Won ; Kang, Hyun Jae ; Baek, Sang Hong ; Cho, Jang Hyun ; Hong, Suk Keun ; Shin, Joon Han ; Oh, Seok Kyu ; Pyun, Wook Bum ; Kwan, Jun ; Hong, Young Joon ; Jeong, Jin Ok ; kang, seokmin ; Choi, Dong Ju. / SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) : A multi-center, retrospective, observational study. In: PloS one. 2014 ; Vol. 9, No. 1.
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title = "SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): A multi-center, retrospective, observational study",
abstract = "Background: Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea. Method and Results: The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45{\%}) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50{\%}) and poor guideline adherence (GAI <50{\%}). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7{\%}; BB, 69.2{\%}; and AA, 65.9{\%}. Overall, 82.7{\%} of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2{\%} and 37.4{\%}, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7{\%} vs. 89.8{\%}, p = 0.003) and re-hospitalization (62.3{\%} vs. 56.4{\%}, p = 0.041) between the good and poor guideline-adherence groups. Conclusions: Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.",
author = "Byungsu Yoo and Jaewon Oh and Hong, {Bum Kee} and Shin, {Dae Hee} and Bae, {Jang Ho} and Yang, {Dong Heon} and Shim, {Wan Joo} and Kim, {Hyung Seop} and Kim, {Su Hong} and Choi, {Jin Oh} and Chun, {Woo Jung} and Go, {Choong Won} and Kang, {Hyun Jae} and Baek, {Sang Hong} and Cho, {Jang Hyun} and Hong, {Suk Keun} and Shin, {Joon Han} and Oh, {Seok Kyu} and Pyun, {Wook Bum} and Jun Kwan and Hong, {Young Joon} and Jeong, {Jin Ok} and seokmin kang and Choi, {Dong Ju}",
year = "2014",
month = "1",
day = "27",
doi = "10.1371/journal.pone.0086596",
language = "English",
volume = "9",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "1",

}

Yoo, B, Oh, J, Hong, BK, Shin, DH, Bae, JH, Yang, DH, Shim, WJ, Kim, HS, Kim, SH, Choi, JO, Chun, WJ, Go, CW, Kang, HJ, Baek, SH, Cho, JH, Hong, SK, Shin, JH, Oh, SK, Pyun, WB, Kwan, J, Hong, YJ, Jeong, JO, kang, S & Choi, DJ 2014, 'SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): A multi-center, retrospective, observational study', PloS one, vol. 9, no. 1, e86596. https://doi.org/10.1371/journal.pone.0086596

SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) : A multi-center, retrospective, observational study. / Yoo, Byungsu; Oh, Jaewon; Hong, Bum Kee; Shin, Dae Hee; Bae, Jang Ho; Yang, Dong Heon; Shim, Wan Joo; Kim, Hyung Seop; Kim, Su Hong; Choi, Jin Oh; Chun, Woo Jung; Go, Choong Won; Kang, Hyun Jae; Baek, Sang Hong; Cho, Jang Hyun; Hong, Suk Keun; Shin, Joon Han; Oh, Seok Kyu; Pyun, Wook Bum; Kwan, Jun; Hong, Young Joon; Jeong, Jin Ok; kang, seokmin; Choi, Dong Ju.

In: PloS one, Vol. 9, No. 1, e86596, 27.01.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR)

T2 - A multi-center, retrospective, observational study

AU - Yoo, Byungsu

AU - Oh, Jaewon

AU - Hong, Bum Kee

AU - Shin, Dae Hee

AU - Bae, Jang Ho

AU - Yang, Dong Heon

AU - Shim, Wan Joo

AU - Kim, Hyung Seop

AU - Kim, Su Hong

AU - Choi, Jin Oh

AU - Chun, Woo Jung

AU - Go, Choong Won

AU - Kang, Hyun Jae

AU - Baek, Sang Hong

AU - Cho, Jang Hyun

AU - Hong, Suk Keun

AU - Shin, Joon Han

AU - Oh, Seok Kyu

AU - Pyun, Wook Bum

AU - Kwan, Jun

AU - Hong, Young Joon

AU - Jeong, Jin Ok

AU - kang, seokmin

AU - Choi, Dong Ju

PY - 2014/1/27

Y1 - 2014/1/27

N2 - Background: Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea. Method and Results: The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45%) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50%) and poor guideline adherence (GAI <50%). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7%; BB, 69.2%; and AA, 65.9%. Overall, 82.7% of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2% and 37.4%, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups. Conclusions: Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.

AB - Background: Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea. Method and Results: The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45%) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50%) and poor guideline adherence (GAI <50%). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7%; BB, 69.2%; and AA, 65.9%. Overall, 82.7% of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2% and 37.4%, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups. Conclusions: Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.

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