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《2020年美国心脏病学会/美国心脏协会成人心力衰竭临床绩效与质量指标2024年更新:美国心脏协会/美国心脏病学会绩效指标联合委员会报告》

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.

作者信息

Kittleson Michelle M, Breathett Khadijah, Ziaeian Boback, Aguilar David, Blumer Vanessa, Bozkurt Biykem, Diekemper Rebecca L, Dorsch Michael P, Heidenreich Paul A, Jurgens Corrine Y, Khazanie Prateeti, Koromia George Augustine, Van Spall Harriette G C

出版信息

J Am Coll Cardiol. 2024 Sep 17;84(12):1123-1143. doi: 10.1016/j.jacc.2024.05.014. 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

本文档描述了适用于公开报告或按绩效付费计划的心力衰竭性能指标,旨在作为《2020美国心脏病学会/美国心脏协会成人心力衰竭临床性能和质量指标:美国心脏病学会/美国心脏协会性能指标工作组报告》的重点更新内容。新的性能指标取自《2022美国心脏协会/美国心脏病学会/心力衰竭学会心力衰竭管理指南:美国心脏病学会/美国心脏协会临床实践指南联合委员会报告》,并从最强推荐(1类或3类)中选取。相比之下,质量指标可能没有那么多证据基础,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不适合公开报告或按绩效付费计划的指标。新的性能指标包括射血分数保留的心力衰竭患者的最佳血压控制、射血分数降低的心力衰竭患者使用钠-葡萄糖协同转运蛋白2抑制剂以及住院患者使用指南指导的药物治疗。新的质量指标包括射血分数轻度降低和保留的心力衰竭患者使用钠-葡萄糖协同转运蛋白2抑制剂、慢性继发性严重二尖瓣反流干预前指南指导的药物治疗的优化、射血分数改善的心力衰竭患者继续使用指南指导的药物治疗、识别已知的心血管疾病风险和健康的社会决定因素、针对心肌病患者的避孕和妊娠风险进行以患者为中心的咨询,以及在解读评估转甲状腺素蛋白心脏淀粉样变性的骨闪烁扫描时进行单克隆蛋白筛查以排除轻链淀粉样变性的必要性。

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