Aims Heart failure (HF) remains a major public health problem with increasing prevalence in China. This study evaluated the clinical performance and quality measures for HF management to identify gaps in the standardization of care for patients hospitalized for HF in China. Methods and results Following the results of China-HF stage 1(2012-2015), the second stage of the China-HF was launched in 2017. Among 113 hospitals with >= 100 cases, the China-HF Stage II assessed the quality of care measures for HF and compared results with previous data in China and the US-based Get with The Guidelines-Heart Failure (GWTG-HF) registries. In total, 34 938 patients hospitalized with HF were enrolled from January 2017 to October 2020. Echocardiographic left ventricular function and natriuretic peptide test were performed in 93.7% and 93.0% of the cases, respectively. Adherence to standardized guidelines in China-HF stage II was higher than that in the China-HF stage I, but generally lower than GWTG-HF registry with 78.2% of eligible patients was prescribed oral diuretics, 78.7% renin-angiotensin-system inhibitors, and 82.2% beta-blockers. Implantable cardioverter-defibrillators and cardiac resynchronization devices were implanted in 3.9% and 14.6%, respectively. In contrast, the proportion of eligible patients discharged with spironolactone (87.8%) was higher than GWTG-HF. The median length of hospitalization was 9 (6, 12) days, and 938 (2.8%) patients died or withdrew from treatment during hospitalization. Conclusions Despite significant improvements in the use of guideline-recommended testing and therapy, there remain major gaps in quality of care for patients hospitalized for HF in China that are generally larger than gaps observed in the United States.
[1]Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, State Key Lab Cardiovasc Dis,Heart Failure Ctr, 167 Beilishi Rd, Beijing 10037, Peoples R China.
[2]Zhengzhou Univ, Peoples Hosp, Henan Prov Peoples Hosp, Dept Cardiol, Zhengzhou, Peoples R China.
[3]Zhengzhou Univ, Dept Cardiol, Cent China Fuwai Hosp, Zhengzhou, Peoples R China.
[4]Duke Clin Res Inst, Durham, NC USA.
[5]Duke Univ, Div Cardiol, Sch Med, Durham, NC USA.
[6]Univ Calif San Diego, Div Cardiol, San Diego, CA 92103 USA.
[7]Univ Mississippi, Med Ctr, Dept Med, Jackson, MS 39216 USA.
[8]Lanzhou Univ, Dept Cardiol, Hosp 2, Lanzhou, Peoples R China.
[9]Hunan Normal Univ, Affiliated Hosp 1, Hunan Prov Peoples Hosp, Dept Cardiol, Changsha, Peoples R China.
[10]Southeast Univ, Dept Cardiol, Zhongda Hosp, Nanjing, Peoples R China.
[11]Nanjing Univ, Med Sch, Affiliated Hosp, Dept Cardiol,Nanjing Drum Tower Hosp, Nanjing, Peoples R China.
[12]Jilin Univ, China Japan Union Hosp, Dept Cardiol, Changchun, Peoples R China.
[13]Jilin Prov Key Lab Genet Diag Cardiovasc Dis, Changchun, Jilin, Peoples R China.
[14]Shandong Univ, Qilu Hosp, Key Lab Cardiovasc Remodeling & Funct Res, Dept Cardiol,Chinese Minist Educ, Jinan, Peoples R China.
[15]Shandong Univ, Chinese Minist Hlth, Dept Cardiol, Qilu Hosp, Jinan, Peoples R China.
[16]Southern Med Univ, State Key Lab Organ Failure Res, Dept Cardiol, Nanfang Hosp,Key Lab Organ Failure Res,Minist Edu, Guangzhou, Peoples R China.
[17]Army Med Univ, Dept Cardiol, Xinqiao Hosp, Chongqing, Peoples R China.
[18]Harbin Med Univ, Affiliated Hosp 2, Dept Cardiol, Harbin, Peoples R China.
[19]Harbin Med Univ, Key Lab Myocardial Ischem, Minist Educ, Harbin, Peoples R China.
[20]Dalian Med Univ, Affiliated Hosp 1, Inst Cardiovasc Dis, Dept Cardiol, Dalian, Peoples R China.
[21]First Peoples Hosp Yunnan Prov, Dept Cardiol, Kunming, Yunnan, Peoples R China.
[22]Chifeng Coll, Dept Heart Failure, Affiliated Hosp, Chifeng, Peoples R China.
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