TY - JOUR
T1 - Temporal trends for secondary prevention measures among patients hospitalized with coronary artery disease
AU - Get With the Guidelines Steering Committee and Investigators
AU - Kumbhani, Dharam J.
AU - Fonarow, Gregg C.
AU - Cannon, Christopher P.
AU - Hernandez, Adrian F.
AU - Peterson, Eric D.
AU - Peacock, W. Frank
AU - Laskey, Warren K.
AU - Deedwania, Prakash
AU - Grau-Sepulveda, Maria
AU - Schwamm, Lee H.
AU - Bhatt, Deepak L.
N1 - Funding Information:
Funding: Get With The Guidelines-Coronary Artery Disease is a program of the American Heart Association and is supported by an unrestricted educational grant from Merck/Schering-Plough Pharmaceutical . Data collection and management were performed by Outcome, Inc (Cambridge, Mass). The analysis of registry data was performed at Duke Clinical Research Institute (Durham, NC), which also receives funding from the American Heart Association . The sponsor was not involved in the management, analysis, or interpretation of data or the preparation of the manuscript.
Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background Prior studies have noted that in-hospital adherence to secondary prevention measures varied among patients undergoing coronary artery bypass graft surgery, percutaneous coronary revascularization, or no intervention. We sought to study contemporary temporal trends in the in-hospital management of patients with coronary artery disease. Methods By using data from the Get With The Guidelines-Coronary Artery Disease registry, we compared adherence to 6 performance measures (aspirin within 24 hours, discharge on aspirin, discharge on beta-blockers, patients with low ejection fraction discharged on angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, smoking cessation counseling, and use of lipid-lowering medications) in eligible patients with coronary artery disease who underwent coronary artery bypass graft surgery, percutaneous coronary intervention, or no intervention between 2003 and 2008. Results A total of 113,971 patients with coronary artery disease were treated at 193 hospitals. Overall adherence to all 6 quality of care measures improved over time in all 3 treatment groups, but was highest at all time periods in the percutaneous coronary intervention group compared with the coronary artery bypass graft surgery group, whereas the no intervention group had the lowest use of prevention measures at all time points (P <.0001). Likewise, 100% adherence to all 6 measures was superior in the percutaneous coronary intervention group at all time points (P <.0001). On multivariable adjustment for case-mix of patients, the majority of these differences persisted. Conclusions Over the last decade, overall adherence with secondary prevention measures improved significantly in patients hospitalized with coronary artery disease regardless of revascularization strategy. However, there still exist select opportunities for improving adherence, particularly among patients undergoing coronary artery bypass graft surgery or no intervention.
AB - Background Prior studies have noted that in-hospital adherence to secondary prevention measures varied among patients undergoing coronary artery bypass graft surgery, percutaneous coronary revascularization, or no intervention. We sought to study contemporary temporal trends in the in-hospital management of patients with coronary artery disease. Methods By using data from the Get With The Guidelines-Coronary Artery Disease registry, we compared adherence to 6 performance measures (aspirin within 24 hours, discharge on aspirin, discharge on beta-blockers, patients with low ejection fraction discharged on angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, smoking cessation counseling, and use of lipid-lowering medications) in eligible patients with coronary artery disease who underwent coronary artery bypass graft surgery, percutaneous coronary intervention, or no intervention between 2003 and 2008. Results A total of 113,971 patients with coronary artery disease were treated at 193 hospitals. Overall adherence to all 6 quality of care measures improved over time in all 3 treatment groups, but was highest at all time periods in the percutaneous coronary intervention group compared with the coronary artery bypass graft surgery group, whereas the no intervention group had the lowest use of prevention measures at all time points (P <.0001). Likewise, 100% adherence to all 6 measures was superior in the percutaneous coronary intervention group at all time points (P <.0001). On multivariable adjustment for case-mix of patients, the majority of these differences persisted. Conclusions Over the last decade, overall adherence with secondary prevention measures improved significantly in patients hospitalized with coronary artery disease regardless of revascularization strategy. However, there still exist select opportunities for improving adherence, particularly among patients undergoing coronary artery bypass graft surgery or no intervention.
KW - Angioplasty Bypass Coronary Disease Registries Surgery
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U2 - 10.1016/j.amjmed.2014.11.013
DO - 10.1016/j.amjmed.2014.11.013
M3 - Article
C2 - 25433302
AN - SCOPUS:84992094333
SN - 0002-9343
VL - 128
SP - 426.e1-426.e9
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 4
ER -