Physicians slower to incorporate newer heart drug ...( rs analyzed how 113595 patients were t...),Health

rs analyzed how 113,595 patients were treated at 434 U.S. hospitals as a part of a national effort to improve the outcomes of patients with heart disease. They monitored the use of specific drugs and physician recommendations both while in the hospital and at discharge -- that have been established as national guidelines by the American College of Cardiology (ACC) and the AHA.

For the analysis, Mehta drew on the database of a national quality improvement initiative known as CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC and AHA Guidelines). CRUSADE maintains a national registry of data collected from more than 400 hospitals nationwide and then reports back to each hospital every three months on their adherence to the guidelines.

The guidelines serve as a national model for optimal care of patients who arrive at the hospital with symptoms of a possible heart attack, such as chest pain (unstable angina), irregular readings on an electrocardiograph or elevated chemical markers of cell death.

The guidelines -- adopted after large-scale clinical trials demonstrated the effectiveness of specific therapies in saving lives -- focus on giving suspected heart attack patients anti-platelet medications, heparin, glycoprotein IIb/IIIa inhibitors (clot inhibitors) or beta-blockers within the first 24 hours of admission. The guidelines also call for prescribing such drugs as aspirin, beta-blockers, ACE inhibitors or statins after discharge, as well as recommendations for cardiac rehabilitation, smoking cessation and dietary modification.

"We found that most of the hospitals participating in CRUSADE have demonstrated substantial improvements in their care of heart patients," said Duke cardiologist E. Magnus Ohman, M.D., who also serves as CRUSADE executive chairman. "We hope that these promising results will motivate more hospitals to participate in quality improvemen
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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
14-Nov-2005

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