PMID: 9164376May 26, 1997Paper

Heart failure treatment with angiotensin-converting enzyme inhibitors in hospitalized Medicare patients in 10 large states. The Large State Peer Review Organization Consortium

Archives of Internal Medicine

Abstract

Angiotensin-converting enzyme (ACE) inhibitors have been proved to reduce mortality, rates of hospitalization, and disease progression in patients with heart failure. Investigators have suggested that ACE inhibitors are underused in heart failure. We examined the use of ACE inhibitors and the documentation of cardiac ejection fractions (EFs) in Medicare patients admitted to acute care hospitals with a principal diagnosis of heart failure. A random sample of at least 600 medical records in each of 10 populous states was retrospectively abstracted by peer review organizations. A total of 6749 records were reviewed of patients aged 65 years and older who were discharged in 1993 and 1994. The review tool was adapted from the Heart Failure Guidelines disseminated by the Agency for Health Care Policy and Research. An ideal candidate cohort was created of patients most likely to benefit from ACE inhibitors on the basis of their EF values (< 40%), renal function, absence of hyperkalemia, and absence of other contraindications. Fifty-five percent (95% confidence interval, 54%-56%) of patients received ACE inhibitors at discharge. In the ideal candidate group, 73% (95% confidence interval, 71%-75%) of patients received ACE inhibitors at ...Continue Reading

Citations

Feb 7, 2001·Clinical Cardiology·J B O'Connell
Apr 4, 2003·Aging Clinical and Experimental Research·Raffaele Antonelli IncalziUNKNOWN Gruppo Italiano di Farmacovigilanza nell'Anziano
Jan 4, 2001·Current Opinion in Cardiology·A S Betkowski, P J Hauptman
Nov 11, 1999·Pharmacotherapy·A B Luzier, L DiTusa
Aug 18, 2004·The American Journal of the Medical Sciences·Ali Ahmed, Louis J Dell'Italia
Apr 3, 2003·Congestive Heart Failure·Cheryl L DischerT Barry Levine
May 31, 2003·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Javed ButlerManoj K Jain
May 31, 2001·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·C HarringtonJ Newman

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