Evidence map›Paper›PMID 22139085›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2012

Implementation of pharmacotherapy guidelines in heart failure: experience from the German Competence Network Heart Failure.

C Zugck, J Franke, G Gelbrich, L Frankenstein, T Scheffold, S Pankuweit, H D Duengen, V Regitz-Zagrosek, B Pieske, T Neumann and 5 more

Abstract read
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In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. The effect of placebo adherence on reducing cardiovascular mortality: a meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2014
    Pooled it
  3. One-year outcome after CRT implantation in NYHA class IV in comparison to NYHA class III patients.Clinical research in cardiology : official journal of the German Cardiac Society · 2013
    Trial
  4. Observational
  5. Article
  6. Article
  7. Treatment of chronic heart failure in Germany: a retrospective database study.Clinical research in cardiology : official journal of the German Cardiac Society · 2017
    Observational
  8. Review
  9. Article
  10. General practitioners' adherence to chronic heart failure guidelines regarding medication: the GP-HF study.Clinical research in cardiology : official journal of the German Cardiac Society · 2016
    Article
  11. Effects of spironolactone on ventricular-arterial coupling in patients with chronic systolic heart failure and mild symptoms.Clinical research in cardiology : official journal of the German Cardiac Society · 2015
    Article
  12. Substernal lead implantation: a novel option to manage DFT failure in S-ICD patients.Clinical research in cardiology : official journal of the German Cardiac Society · 2015
    Article
  13. Clinical and echocardiographic correlates of serum copper and zinc in acute and chronic heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2014
    Article
  14. ICD therapy for primary prevention of sudden cardiac death after Mustard repair for d-transposition of the great arteries.Clinical research in cardiology : official journal of the German Cardiac Society · 2014
    Article
  15. Article
  16. Registry in Germany focusing on level-specific and evidence-based decision finding in the treatment of heart failure: REFLECT-HF.Clinical research in cardiology : official journal of the German Cardiac Society · 2014
    Observational
  17. Observational
  18. Portable recording for detecting sleep disorder breathing in patients under the care of a heart failure clinic.Clinical research in cardiology : official journal of the German Cardiac Society · 2013
    Article
  19. Atrial standstill in a patient with progressive severe heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2013
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 1 country.

C ZugckDepartment of Cardiology, Angiology, Pulmonology, University of Heidelberg, Heidelberg, Germany. Christian.Zugck@med.uni-heidelberg.de
J Franke
G Gelbrich
L Frankenstein
T Scheffold
S Pankuweit
H D Duengen
V Regitz-Zagrosek
B Pieske
T Neumann
M Rauchhaus
C E Angermann
H A Katus
G E Ertl
S Störk
Heidelberg University · DECharité - Universitätsmedizin Berlin · DEUniversity of Würzburg · DEPhilipps University of Marburg · DEUniversitätsklinikum Würzburg · DEUniversity of Göttingen · DEWest German Heart and Vascular Center Essen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo evaluate the implementation of current pharmacotherapy guidelines of heart failure and to identify factors associated with high pharmacotherapy guideline adherence in heart failure patients. METHODS AND

resultsWe pooled data from seven studies performed in the context of the German Competence Network Heart Failure selecting patients with chronic systolic heart failure and left ventricular ejection fraction (LVEF) <45% (n = 2,682). The quality of pharmacotherapy was evaluated by calculating the guideline adherence indicator (GAI), which considers three (GAI-3) or five (GAI-5) of the recommended heart failure substance classes and accounts for respective contraindications. GAI-3 was categorized as perfect (GAI = 100%: 71% of the cohort), medium (GAI = 50-99%: 22%), and poor adherence (GAI <50%: 7%). In ordinal regression, the following factors were positively associated with perfect adherence: history of revascularization (odds ratio 1.59, 95% confidence interval 1.27-1.98), prior ICD implantation (2.29, 1.76-2.98), and LV ejection fraction <30% (1.45, 1.19-1.76), whereas age (per 10 years; 0.82, 0.77-0.89), NYHA III/IV (0.15, 0.12-0.18), unknown duration of heart failure (0.69, 0.53-0.89), and antidepressant medication (0.61, 0.42-0.88) were negatively associated with perfect adherence. Better GAI-3 at baseline predicted favorable changes of LV ejection fraction and end-diastolic diameter after 1 year. One-year mortality risk was closely related to GAI-3 in both groups of NYHA functional class I/II (excellent vs. poor GAI-3: 7.2 vs. 14.5%, log rank = 0.004) and class III/IV (13.5 vs. 21.5%, log rank = 0.005).

conclusionsThis large pooled analysis showed that a high level of guideline adherence is achievable in the context of clinical studies. Those receiving and tolerating optimal pharmacotherapy experience a better prognosis. Nevertheless, the implementation of heart failure medication needs further improvement in female and elderly patients, especially those in NYHA functional class >II and patients with LVEF ≥30%.

Indexed as

Guideline AdherencePractice Guidelines as TopicAdultAgedAged, 80 and overAge FactorsChronic DiseaseClinical Trials as TopicFemaleGermanyHeart Failure, SystolicHumansMaleMiddle AgedPrognosisRegression Analysis

Identifiers

PMID22139085
OpenAlexW2001908127

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.