Abstract 23237: Improvement in Quality of Care for Atrial Fibrillation in Get With The Guidelines - Atrial Fibrillation (GWTG-AFIB)
Introduction: Recent quality improvement efforts to improve anticoagulation in patients with atrial fibrillation (AF), like the nationwide PINNACLE registry, have had limited success in improving guideline adherence. We sought to determine if participating in GWTG-AFIB would be associated with high rates of compliance with anticoagulation using the new ACCF/AHA AF performance measure definitions.
Methods: We included GWTG-AFIB patients with a primary/secondary diagnosis of AF enrolled at participating centers with >90% complete data. Patients with documented absolute contraindications to oral anticoagulation were described but not included in the primary analysis. Adherence to the ACCF/AHA performance measures for AF was reported and the adjusted association with adherence & outcomes was determined.
Results: Results will include patient admission characteristics and the distribution of reasons for contraindications to oral anticoagulation. The presentation will also detail rates of oral anticoagulation in patients with CHA2DS2-VASc scores of ≥2 in the overall population and subgroups as well as in patients with scores of 0-1. Variation in oral anticoagulation prescription at discharge across all sites and adherence to performance measures over time will be detailed. Multivariable factors associated with discharge oral anticoagulation in patients with CHA2DS2-VASc scores of ≥2 will be presented. We will report adjusted in-hospital mortality and stroke according to oral anticoagulation adherence. Preliminary data from a 12-month sample are shown in the Figure.
Conclusion: Among hospitals participating in GWTG-AFIB, use of stroke prevention therapy at discharge in eligible patients was high and improved over time. These data suggest that a high degree of adherence to stroke prevention and AF quality measures is possible. Furthermore, these data demonstrate that improvements to rates greater than 90% are achievable in clinical practice.
Author Disclosures: J.P. Piccini: Research Grant; Significant; ARCA biopharma, Boston Scientific, Gilead, Johnson & Johnson, ResMed, St Jude Medical. Other Research Support; Significant; AHRQ. Consultant/Advisory Board; Modest; BMS-Pfizer, Spectranetics, Medtronic, GSK. M. Cox: None. G.C. Fonarow: Consultant/Advisory Board; Modest; Janssen Pharmaceuticals, Medtronic. J. Butler: None. A.B. Curtis: Research Grant; Significant; Medtronic, St Jude Medical, Janssen Pharmaceuticals, Daiichi Sankyo, Sanofi Aventis, BMS-Pfizer, Biosense Webster. N. Desai: None. M. Fang: None. P.J. McCabe: None. R.L. Page: None. M. Turakhia: Research Grant; Significant; Janssen Pharmaceuticals. W.R. Lewis: None.
- © 2016 by American Heart Association, Inc.