Treatment performance measures affect clinical outcomes in patients with acute systolic heart failure: Report from the Korean Heart Failure Registry

Youngjin Youn, Byungsu Yoo, Junwon Lee, Jang Young Kim, Seong Woo Han, Eun Seok Jeon, Myeong Chan Cho, Jae Joong Kim, seokmin kang, Shung Chull Chae, Byung Hee Oh, Dong Ju Choi, Myung Mook Lee, Kyu Hyung Ryu

Research output: Contribution to journalArticle

31 Citations (Scopus)

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. Methods and 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), angiotensinreceptor 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.

Original languageEnglish
Pages (from-to)1151-1158
Number of pages8
JournalCirculation Journal
Volume76
Issue number5
DOIs
Publication statusPublished - 2012 May 2

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Systolic Heart Failure
Angiotensin-Converting Enzyme Inhibitors
Registries
Heart Failure
Odds Ratio
Confidence Intervals
Mineralocorticoid Receptor Antagonists
Left Ventricular Dysfunction
Korea
Mortality
Therapeutics
Prescriptions
Hospitalization
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Youn, Youngjin ; Yoo, Byungsu ; Lee, Junwon ; Kim, Jang Young ; Han, Seong Woo ; Jeon, Eun Seok ; Cho, Myeong Chan ; Kim, Jae Joong ; kang, seokmin ; Chae, Shung Chull ; Oh, Byung Hee ; Choi, Dong Ju ; Lee, Myung Mook ; Ryu, Kyu Hyung. / Treatment performance measures affect clinical outcomes in patients with acute systolic heart failure : Report from the Korean Heart Failure Registry. In: Circulation Journal. 2012 ; Vol. 76, No. 5. pp. 1151-1158.
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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. Methods and 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), angiotensinreceptor 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.",
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Treatment performance measures affect clinical outcomes in patients with acute systolic heart failure : Report from the Korean Heart Failure Registry. / Youn, Youngjin; Yoo, Byungsu; Lee, Junwon; Kim, Jang Young; Han, Seong Woo; Jeon, Eun Seok; Cho, Myeong Chan; Kim, Jae Joong; kang, seokmin; Chae, Shung Chull; Oh, Byung Hee; Choi, Dong Ju; Lee, Myung Mook; Ryu, Kyu Hyung.

In: Circulation Journal, Vol. 76, No. 5, 02.05.2012, p. 1151-1158.

Research output: Contribution to journalArticle

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T1 - Treatment performance measures affect clinical outcomes in patients with acute systolic heart failure

T2 - Report from the Korean Heart Failure Registry

AU - Youn, Youngjin

AU - Yoo, Byungsu

AU - Lee, Junwon

AU - Kim, Jang Young

AU - Han, Seong Woo

AU - Jeon, Eun Seok

AU - Cho, Myeong Chan

AU - Kim, Jae Joong

AU - kang, seokmin

AU - Chae, Shung Chull

AU - Oh, Byung Hee

AU - Choi, Dong Ju

AU - Lee, Myung Mook

AU - Ryu, Kyu Hyung

PY - 2012/5/2

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N2 - 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. Methods and 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), angiotensinreceptor 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.

AB - 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. Methods and 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), angiotensinreceptor 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.

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