Quality of Heart Failure Management: A Comparison of Care Between a Comprehensive Heart Failure Program and a General Cardiology Practice
Article first published online: 28 DEC 2009
© 2009 Wiley Periodicals, Inc.
Congestive Heart Failure
Volume 16, Issue 2, pages 65–70, March/April 2010
How to Cite
Asghar, H. and Rahko, P. S. (2010), Quality of Heart Failure Management: A Comparison of Care Between a Comprehensive Heart Failure Program and a General Cardiology Practice. Congestive Heart Failure, 16: 65–70. doi: 10.1111/j.1751-7133.2009.00136.x
- Issue published online: 11 MAR 2010
- Article first published online: 28 DEC 2009
- Manuscript received July 15, 2009; revised October 6, 2009; accepted October 22, 2009
This study evaluates adherence to guidelines by heart failure clinicians (HFCs) vs general cardiologists (GCs) for use of implantable cardioverter-defibrillators (ICDs), biventricular pacing devices (cardiac resynchronization therapy; CRT), and use of medications for heart failure (HF). The authors reviewed 563 patients with HF and an ejection fraction ≤35% for adherence to the 2005 American College of Cardiology/American Heart Association HF guidelines for the use of ICDs, CRT, and medications. There were 324 HFC and 239 GC patients. CRT guidelines were appropriately followed in 86% of HFC and 81% of GC patients ( P=NS). For primary arrhythmia prevention, an ICD was implanted in 107 (42%) HFC and 50 (25%) GC patients ( P<.004). Guidelines were appropriately followed in 77% of HFC and 74% of GC patients ( P=NS). For medications, dose intensity of diuretics, β-blockers, and angiotensin-converting enzyme inhibitors was significantly greater in HFC than GC patients. Guideline-recommended β-blockers were more frequently utilized by HFCs (97%) than GCs (82%). In conclusion, HFCs and GCs appropriately follow guidelines in the majority of cases, but HFCs use appropriate medications at higher dose intensity.
Congest Heart Fail. 2010;16:65–70. © 2009 Wiley Periodicals, Inc.