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Guidelines program improved adherence among patients with diabetes, ACS
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LOS ANGELES — New data suggest significant and continued improvements in most performance measures in ACS patients with and without diabetes treated at hospitals participating in the American Heart Association’s Get With The Guidelines Program.
Prakash C. Deedwania, MD, FAHA of the VA Central California Health Care System/University of California, San Francisco, and colleagues evaluated and compared the characteristics, length of hospital stay, in-hospital mortality and temporal trends in adherence to guideline-based therapy upon discharge in patients with and without diabetes. Their study included 151,270 patients admitted with ACS from 2002 to 2008 at more than 400 sites participating in the program.
Prakash C. Deedwania
Deedwania reported that patients with diabetes (n=48,938; 32%) had a higher rate of non-ST-segment elevation MI and longer length of hospital stay with higher incidence for in-hospital mortality (6.35%) compared with those without diabetes (4.98%).
Secular trend analyses demonstrated a significant improvement in guideline-based therapies among patients with and without diabetes from 2002 to 2008 (P<.0001). Among patients with diabetes, aspirin use improved from 92% in 2002 to 98% in 2008; beta-blocker use from 90% to 98%; ACE inhibitors or angiotensin receptor blockers for acute MI from 62% to 84%; and lipid-lowering therapy from 74% to 91% (P<.05 for all). However, upon discharge, patients with diabetes were less likely to be on renin-angiotensin system blocking agents. There was also improvement in trend for achieving BP control, although in 2008, only 74% of patients were discharged with BP<140/90 mm Hg.
Based on these data, the researchers said, “Additional opportunities exist for use of ACE inhibitors and angiotensin receptor blockers and BP control at discharge,” the researchers said. – by Samantha Costa
For more information:
Deedwania PC. Abstract #12341. Presented at: the American Heart Association Scientific Sessions; Nov. 3-7, 2012; Los Angeles.
Disclosure: Deedwania reports receiving speakers’ bureau and consultancy fees from Forest, Pfizer and Takeda.