Abstract 4138420: Impact of the American Heart Association Get-With-The-Guidelines Heart Failure A.S.I.A. Program in Taiwanese hospitals

Abstract

Introduction: The American Heart Association (AHA) Get With the Guidelines – Heart Failure program has been implemented for years in the United States with extensive literature supporting its benefits. In 2022, the AHA Heart Failure Adherence to Science Implementation in Asia (HF A.S.I.A.) powered by Get With The Guidelines program was first introduced in five Asian countries. Research Question: This study aims to explore the impact of this program's implementation in Taiwanese hospitals. Methods: Data were sourced from the Taiwan Society of Cardiology-HF-Registry 2020, a prospective registry that tracks HF cases from 27 hospitals in Taiwan between 2020 and 2024. Among these, four hospitals began participating in the HF A.S.I.A. program in January 2022. This study compared patients from hospitals that participated and did not participate in the HF A.S.I.A. program. Results: A total of 1,933 HF patients with a left ventricular ejection fraction ≤ 40% were included, comprising 460 participants from the HF A.S.I.A. program and 1,473 non-participants. The HF A.S.I.A. group was younger, had significantly lower systolic blood pressure, larger left ventricular diameter, and experienced more frequent prior hospitalizations for HF. However, there were no significant differences between the two groups in terms of baseline heart rate, estimated glomerular filtration rate, blood potassium levels, and most comorbidities. During the study period, due to changes in payment policies, the use of angiotensin receptor neprilysin inhibitor (ARNI) decreased in the non-participant group, while the use of sodium glucose co-transporter 2 inhibitor (SGLT2i) increased. Conversely, the use of ARNI in the HF A.S.I.A. group continued to rise in line with guideline recommendations and the usage of SGLT2i was higher than in the non-participant group. After adjustment, one-year lost to follow-up rate was significantly lower (3.0% vs. 5.6%, p =0.032) and all-cause mortality rate trended non-significantly lower (7.6% vs. 11.4%, p =0.096) among the HF A.S.I.A. group. Conclusion: Despite enrolling sicker patients, participation in HF A.S.I.A. program was associated with higher quality of HF care.