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Prospective evaluation of beta-blocker use at the time of hospital discharge as a heart failure performance measure: results from OPTIMIZE-HF.
J Card Fail. 2007 Nov; 13(9):722-31.JC

Abstract

BACKGROUND

The objective of this study was to prospectively evaluate beta-blocker use at hospital discharge as an indicator of quality of care and outcomes in patients with heart failure (HF).

METHODS AND RESULTS

Data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry for patients hospitalized with HF from 259 hospitals were prospectively collected and analyzed. HF medication contraindications, intolerance, and use at hospital discharge were assessed, along with 60- to 90-day follow-up data in a prespecified cohort. There were 20,118 patients with left ventricular systolic dysfunction. At discharge, 90.6% of patients were eligible to receive beta-blockers, and 83.7% were eligible to receive an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. Eligible patients discharged with beta-blockers were significantly more likely to be treated at follow-up than those not discharged with beta-blockers (93.1% vs 30.5%; P < .0001). Discharge use of beta-blockers in eligible patients was associated with a significant reduction in the adjusted risk of death (hazard ratio: 0.48; 95% confidence interval: 0.32-0.74; P < .001) and death/rehospitalization (odds ratio: 0.74; 95% confidence interval: 0.55-0.99; P = .04), although we cannot completely exclude the possibility of residual confounding.

CONCLUSIONS

Discharge beta-blocker use in HF appeared to be well tolerated, improved treatment rates, and was associated with substantially lower postdischarge mortality risk. These data provide additional evidence that supports beta-blocker use at hospital discharge in eligible patients as an HF performance measure.

Authors+Show Affiliations

Department of Medicine, University of California Los Angeles Medical Center, Los Angeles, California 90095-1679, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17996820

Citation

Fonarow, Gregg C., et al. "Prospective Evaluation of Beta-blocker Use at the Time of Hospital Discharge as a Heart Failure Performance Measure: Results From OPTIMIZE-HF." Journal of Cardiac Failure, vol. 13, no. 9, 2007, pp. 722-31.
Fonarow GC, Abraham WT, Albert NM, et al. Prospective evaluation of beta-blocker use at the time of hospital discharge as a heart failure performance measure: results from OPTIMIZE-HF. J Card Fail. 2007;13(9):722-31.
Fonarow, G. C., Abraham, W. T., Albert, N. M., Stough, W. G., Gheorghiade, M., Greenberg, B. H., O'Connor, C. M., Sun, J. L., Yancy, C. W., & Young, J. B. (2007). Prospective evaluation of beta-blocker use at the time of hospital discharge as a heart failure performance measure: results from OPTIMIZE-HF. Journal of Cardiac Failure, 13(9), 722-31.
Fonarow GC, et al. Prospective Evaluation of Beta-blocker Use at the Time of Hospital Discharge as a Heart Failure Performance Measure: Results From OPTIMIZE-HF. J Card Fail. 2007;13(9):722-31. PubMed PMID: 17996820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective evaluation of beta-blocker use at the time of hospital discharge as a heart failure performance measure: results from OPTIMIZE-HF. AU - Fonarow,Gregg C, AU - Abraham,William T, AU - Albert,Nancy M, AU - Stough,Wendy Gattis, AU - Gheorghiade,Mihai, AU - Greenberg,Barry H, AU - O'Connor,Christopher M, AU - Sun,Jie Lena, AU - Yancy,Clyde W, AU - Young,James B, AU - ,, PY - 2007/01/22/received PY - 2007/05/17/revised PY - 2007/06/20/accepted PY - 2007/11/13/pubmed PY - 2008/2/9/medline PY - 2007/11/13/entrez SP - 722 EP - 31 JF - Journal of cardiac failure JO - J Card Fail VL - 13 IS - 9 N2 - BACKGROUND: The objective of this study was to prospectively evaluate beta-blocker use at hospital discharge as an indicator of quality of care and outcomes in patients with heart failure (HF). METHODS AND RESULTS: Data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry for patients hospitalized with HF from 259 hospitals were prospectively collected and analyzed. HF medication contraindications, intolerance, and use at hospital discharge were assessed, along with 60- to 90-day follow-up data in a prespecified cohort. There were 20,118 patients with left ventricular systolic dysfunction. At discharge, 90.6% of patients were eligible to receive beta-blockers, and 83.7% were eligible to receive an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. Eligible patients discharged with beta-blockers were significantly more likely to be treated at follow-up than those not discharged with beta-blockers (93.1% vs 30.5%; P < .0001). Discharge use of beta-blockers in eligible patients was associated with a significant reduction in the adjusted risk of death (hazard ratio: 0.48; 95% confidence interval: 0.32-0.74; P < .001) and death/rehospitalization (odds ratio: 0.74; 95% confidence interval: 0.55-0.99; P = .04), although we cannot completely exclude the possibility of residual confounding. CONCLUSIONS: Discharge beta-blocker use in HF appeared to be well tolerated, improved treatment rates, and was associated with substantially lower postdischarge mortality risk. These data provide additional evidence that supports beta-blocker use at hospital discharge in eligible patients as an HF performance measure. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/17996820/Prospective_evaluation_of_beta_blocker_use_at_the_time_of_hospital_discharge_as_a_heart_failure_performance_measure:_results_from_OPTIMIZE_HF_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(07)00942-6 DB - PRIME DP - Unbound Medicine ER -