Guidelines-recommended CVD medication linked to increased HF survival
MedWire News: Heart failure patients’ adherence to guidelines for the use of cardiovascular disease (CVD) medication appears to increase over time, and this increase is linked to improved patient survival regardless of age or gender, researchers suggest.
“This study shows that increased use of medication according to guidelines might occur without interventions targeting medication use” say Lutz Frankenstein (University of Heidelberg, Germany) and colleagues in the European Journal of Heart Failure.
They investigated the level of adherence to CVD medication in 3292 Caucasian adult chronic heart failure (CHF) outpatients, who started CVD medication at least 1 month prior to the study. To account for any effect of the CHF national guidelines update in 2001, the patients were observed in two cohorts: a before-update cohort, from 1994 to 2000 (n=1481), and an after-update cohort, from 2001 to 2007 (n=1811).
All patients were followed-up for at least 12 months and adherence was defined as the presence of complete compliance and by calculation of a guideline adherence indicator (GAI).
Following correction for comorbidities, the results showed a significant increase in complete compliance and in GAI (reflecting use of ACE inhibitors, angiotensin receptor blockers, beta blockers and aldosterone antagonists) in both cohorts.
In addition, 1- and 3-year mortality rates fell significantly in 2001–2007 from those seen in 1994–2000, from 14.1% to 4.8% and 29.5% to 10.9%, respectively, regardless of patient age or gender. GAI score significantly predicted lower overall mortality, with every 10% increase in GAI associated with an additional 8% reduction in overall mortality risk.
The researchers conclude: “Our data would argue in favor of the best possible implementation of guidelines irrespective of age or sex.”
They note, however, that the lack of ethnic diversity in the study group may prevent reliable application of the findings to non-Caucasian ethnicities.
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By Lauretta Ihonor