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News

New data highlights heart failure treatment variances across the USA

Medtronic : 07 November, 2007  (New Product)
New baseline data from the largest study of US based heart failure (HF) patients in the outpatient setting demonstrate significant under utilisation of many guideline-indicated life-saving medical and device therapies.
In fact, data from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) study show substantial variances in the use of all guideline-recommended treatments for HF patients.

Findings from IMPROVE HF were presented at Scientific Sessions 2007, the annual congress of the American Heart Association. The study is sponsored by Medtronic.

According to the baseline results, the use of ACE inhibitors/ARBs (angiotensin II receptor blockers) and beta-blockers were relatively high in patients eligible for these therapies (80 percent and 86 percent of eligible patients, respectively). However, fewer patients received other life-saving treatments and devices for which they were eligible based on current medical guidelines. These included:

Aldosterone antagonists (36 percent of eligible patients)

Anticoagulation for atrial fibrillation (69 percent of eligible patients)

Cardiac resynchronization therapy (CRT), including both CRT-defibrillators (CRT-D) and CRT-pacemaker devices (39 percent of eligible patients)

Implantable cardioverter defibrillator (ICD) therapy, including both ICD-only and CRT-D devices (51 percent of eligible patients)

HF education (61 percent of eligible patients).

“More than five million Americans have heart failure, and while there are clear guidelines for how best to treat these patients, appropriate therapies are still underutilised,” said Clyde Yancy, MD, co-chair of the IMPROVE HF Scientific Steering Committee and medical director at the Baylor Heart and Vascular Institute, Baylor University Medical Center, in Dallas, Texas, USA. “Based on the data from this study, the medical community is presented with an opportunity to improve the quality of care for heart failure patients.”

“This is the first study of its kind to document the extent in which heart failure patients in the outpatient cardiology practice setting are receiving optimal treatment, as defined by the most recent treatment guidelines,” said Gregg C Fonarow, MD, co-chair of the IMPROVE HF Scientific Steering Committee and professor of medicine at the University of California at Los Angeles. “The new data demonstrate that alarming treatment gaps exist in the use of evidence-based, guideline recommended therapies in eligible patients with heart failure.”

Earlier IMPROVE HF analyses showed:

Less than 30 percent of patients assessed at baseline were being treated with all therapies for which they were eligible.

Women were less likely than men to receive an ICD when indicated, education about their condition, or anticoagulation treatment for atrial fibrillation.

Older patients were less likely than younger patients to receive certain types of guideline-indicated interventions particularly ICD/CRT-D therapy.
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