实施与指导方针相适应的心脏衰竭 坚持科学,在亚洲实施 (GWTG-HF ASIA) 在台湾的项目
Hung-Yu Chang1,2, Chia-Te Liao3, Paul A Heidenreich4
1Heart Center Cheng Hsin General Hospital Taipei Taiwan.
Journal of the American Heart Association
|December 18, 2025
概括
参与获得与指导方针-心力衰竭坚持科学,在亚洲实施 (GWTG-HF ASIA) 的参与. 该计划在台湾显著增加了指导方针导向医疗疗 (GDMT) 的使用. 这项质量改善计划改善了心力衰竭的护理,并减少了患者对随访的损失.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 改善临床质量 改善临床质量
背景情况:
- 准则导向医学疗法 (GDMT) 对心力衰竭与减少喷射率 (HFrEF) 至关重要,但在亚洲的采用率很低.
- 获得与指导方针-心力衰竭坚持科学,在亚洲的实施 (GWTG-HF ASIA) 为了弥补这个差距,启动了该计划.
- 本研究评估了GWTG-HF A.S.I.A.的影响. 关于在台湾实施GDMT的计划.
研究的目的:
- 评估参与GWTG-HF A.S.I.A.之间的关系. 台湾的HFrEF患者的GDMT计划和实施.
- 为了比较参与和非参与医院之间的GDMT处方率.
- 评估二次结果,包括心声回声学改造,随访损失和死亡率.
主要方法:
- 来自台湾心脏病学会心脏病注册表的1991年HFrEF患者的分析 (2021-2024).
- 4家参与的医院与23家不参与的对照医院进行比较.
- 倾向性得分匹配和概括估计方程来比较GDMT处方趋势和结果.
主要成果:
- 在这两组中,GDMT的使用量都增加了,参与医院的增加明显更大 (4支柱GDMT的aOR为2.73).
- 参与该计划与较高的血管激素受体-尼普利辛抑制剂,SGLT2抑制剂和矿物质皮质体受体对抗剂的比率有关.
- 参与的医院表现出左心室逆转型改造的改善和随访损失显著降低 (0.5%对5.2%).
结论:
- 在GWTG-HF A.S.I.A. 的A.S.I.A. 该计划有效地提高了台湾医院的GDMT处方率.
- 结构化的质量改善举措对于弥合亚洲心血管保健的证据与实践差距至关重要.
- 该计划显示,除了药物坚持之外,该计划对患者的结果产生了积极的影响.
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