Abstract 17402: Improved Medical Therapy for Heart Failure: A Population-Based Perspective
Background: Despite the availability of effective therapies, HF remains a highly prevalent, morbid and costly disease. Few data are available, however, describing changing trends in the use of various cardiac medications to treat patients with HF. The primary objective of this population-based study was to examine decade-long trends (1995-2004) in the use of cardiac medications in patients hospitalized with acute decompensated heart failure (ADHF), including pre-hospital, in-hospital, and discharge medications.
Methods: We reviewed the medical records of 9,748 patients hospitalized with ADHF at all 11 central Massachusetts medical centers and abstracted information on patient’s demographic, clinical, and treatment characteristics.
Results: Between 1995 and 2004 respectively, the use of beta-blockers (26%; 74%), angiotensin pathway inhibitors (50%; 61%), statins (6%; 45%), and aspirin (40%; 63%) increased markedly, while the use of digoxin (55%; 33%), nitrates (68%; 47%), and calcium channel blockers (40%; 30%) declined significantly; nearly all patients received diuretics. Patients with COPD, anemia, incident HF, non-specific symptoms, and women were less likely to receive recommended medications including beta blockers and angiotensin pathway inhibitors than men and patients without these characteristics. In the most recent study year (2004), 82% of patients were discharged on either a beta blocker or an angiotensin pathway inhibitor; however, only 41% were discharged on medications from both recommended classes.
Conclusion: The use of effective HF therapies has increased markedly over time, coincident with a significant decline in the HF hospitalization rate recently observed nationally. Nonetheless, our data suggest that opportunities exist to further improve the use of HF therapeutics.
- © 2012 by American Heart Association, Inc.