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SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): A Multi-Center, Retrospective, Observational Study

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Author(s)
Byung-Su YooJaewon OhBum-Kee HongDae-Hee ShinJang-Ho BaeDong Heon YangWan-Joo ShimHyung-seop KimSu-Hong KimJin-Oh ChoiWoo-Jung ChunChoong-Won GoHyun-Jae KangSang Hong BaekJang-hyun ChoSuk-Keun HongJoon-Han ShinSeok-Kyu OhWook-Bum PyunJun KwanYoung-Joon HongJin-Ok JeongSeok-Min KangDong-Ju Choi
Keimyung Author(s)
Kim, Hyung Seop
Department
Dept. of Internal Medicine (내과학)
Journal Title
PLoS One
Issued Date
2014
Volume
9
Issue
1
Abstract
Background

Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea.

Method and Results

The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45%) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50%) and poor guideline adherence (GAI <50%). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7%; BB, 69.2%; and AA, 65.9%. Overall, 82.7% of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2% and 37.4%, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups.

Conclusions

Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.
Keimyung Author(s)(Kor)
김형섭
Publisher
School of Medicine
Citation
Byung-Su Yoo et al. (2014). SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): A Multi-Center, Retrospective, Observational Study. PLoS One, 9(1), e86596–e86596. doi: 10.1371/journal.pone.0086596
Type
Article
ISSN
1932-6203
DOI
10.1371/journal.pone.0086596
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33692
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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