KC Reporter

A study published in Circulation: Heart Failure reveals that a nationwide heart failure initiative by the American Heart Association has significantly improved care for patients. The research, led by Saint Luke’s Mid America Heart Institute, shows increased use of lifesaving heart failure therapy and better access to care.

Heart failure affects approximately 6.7 million adults in the U.S., with projections rising to 8.7 million by 2030. Many hospitalized with worsening heart failure suffer from reduced ejection fraction (HFrEF), which carries high mortality rates.

Research indicates that quadruple medical therapy—comprising angiotensin receptor-neprilysin inhibitor (ARNi), beta-blocker (BB), mineralocorticoid antagonist (MRA), and sodium-glucose cotransporter 2 inhibitor (SGLTI2i)—improves outcomes for HFrEF patients but is underutilized, with less than 20% receiving it.

In response, the American Heart Association launched IMPLEMENT-HF in 2021, aiming to enhance home health time for heart failure patients across seven U.S. regions, including Kansas City. This initiative focused on increasing quadruple medical therapy use and addressing social needs through its Get With The Guidelines - Heart Failure program.

The study evaluated over 43,500 patients from 67 sites participating in IMPLEMENT-HF. Results show significant improvement in quadruple medical therapy usage at hospital discharge and after 30 days.

Additionally, there was an increase in assessing health-related social needs, linking patients to recovery resources. "This is a major step forward in heart failure care," said Andrew Sauer, MD, lead author of the study from Saint Luke’s Mid America Heart Institute.

While regional implementation varied among performance measures, overall quarterly improvements were noted. The study suggests a scalable model for improving guideline-directed medical therapy utilization in HFrEF while enhancing adherence and equity across demographics.

"The IMPLEMENT-HF initiative demonstrates the power of collaborative, data-driven quality improvement," said Gregg Fonarow, MD from UCLA Health and senior author of the study. He emphasized the importance of increasing healthy days at home for patients as part of this transformative effort.

Further research is recommended to explore how enhanced performance measures like quadruple medical therapy affect clinical outcomes within multidisciplinary initiatives like IMPLEMENT-HF.

Read more about these findings in "Multiregional Implementation Initiative’s Impact on Guideline-Based Performance Measures for Patients Hospitalized with Heart Failure: IMPLEMENT-HF" available in Circulation: Heart Failure.