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2024 年更新版 2020 ACC/AHA 心力衰竭成人临床性能和质量指标:美国心脏协会/美国心脏病学会联合绩效测量委员会的报告。

2024 Update to the 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American Heart Association/American College of Cardiology Joint Committee on Performance Measures.

机构信息

AHA/ACC Joint Committee on Performance Measures.

2022 AHA/ACC Heart Failure Guideline liaison.

出版信息

Circ Cardiovasc Qual Outcomes. 2024 Sep;17(9):e000132. doi: 10.1161/HCQ.0000000000000132. Epub 2024 Aug 8.

Abstract

This document describes performance measures for heart failure that are appropriate for public reporting or pay-for-performance programs and is meant to serve as a focused update of the "2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures." The new performance measures are taken from the "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines" and are selected from the strongest recommendations (Class 1 or Class 3). In contrast, quality measures may not have as much evidence base and generally comprise metrics that might be useful for clinicians and health care organizations for quality improvement but are not yet appropriate for public reporting or pay-for-performance programs. New performance measures include optimal blood pressure control in patients with heart failure with preserved ejection fraction, the use of sodium-glucose cotransporter-2 inhibitors for patients with heart failure with reduced ejection fraction, and the use of guideline-directed medical therapy in hospitalized patients. New quality measures include the use of sodium-glucose cotransporter-2 inhibitors in patients with heart failure with mildly reduced and preserved ejection fraction, the optimization of guideline-directed medical therapy prior to intervention for chronic secondary severe mitral regurgitation, continuation of guideline-directed medical therapy for patients with heart failure with improved ejection fraction, identifying both known risks for cardiovascular disease and social determinants of health, patient-centered counseling regarding contraception and pregnancy risks for individuals with cardiomyopathy, and the need for a monoclonal protein screen to exclude light chain amyloidosis when interpreting a bone scintigraphy scan assessing for transthyretin cardiac amyloidosis.

摘要

本文件描述了心力衰竭的绩效指标,这些指标适用于公开报告或按绩效付费计划,旨在作为对“2020ACC/AHA 心力衰竭成人临床绩效和质量指标:美国心脏病学会/美国心脏协会绩效措施工作组报告”的重点更新。新的绩效指标取自“2022AHA/ACC/HFSA 心力衰竭管理指南:美国心脏病学会/美国心脏协会联合临床实践指南委员会报告”,并选自最强推荐(类 1 或类 3)。相比之下,质量指标的证据基础可能较少,通常包括对临床医生和医疗保健组织进行质量改进可能有用但尚未适用于公开报告或按绩效付费计划的指标。新的绩效指标包括心力衰竭射血分数保留患者的最佳血压控制、心力衰竭射血分数降低患者使用钠-葡萄糖共转运蛋白-2 抑制剂以及住院患者使用指南指导的药物治疗。新的质量指标包括心力衰竭射血分数轻度降低和保留患者使用钠-葡萄糖共转运蛋白-2 抑制剂、慢性继发性重度二尖瓣反流干预前优化指南指导的药物治疗、心力衰竭射血分数改善患者继续指南指导的药物治疗、识别心血管疾病的已知风险和健康的社会决定因素、对心肌病患者进行避孕和妊娠风险的以患者为中心的咨询、以及在解释评估转甲状腺素蛋白心脏淀粉样变性的骨闪烁扫描时排除轻链淀粉样变性的单克隆蛋白筛查的需要。

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