The 2024 ACC/AHA update introduces new performance measures for heart failure, including optimal blood pressure control in HFpEF, SGLT2 inhibitor use in HFrEF, and initiation of guideline-directed medical therapy during hospitalization.
This document updates the 2020 ACC/AHA heart failure measures with 3 new performance measures and 6 new quality measures to align with the 2022 AHA/ACC/HFSA heart failure guidelines.
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.
“The principle behind these [types of] documents in general is to create measures that are based on evidence that can be useful for clinicians and healthcare organizations to really improve outcomes for their patients. There's so much wealth in the heart failure guidelines, there's over a hundred recommendations, but [we chose] to highlight those we felt were the most pivotal and important for clinicians and healthcare organizations alike to incorporate into care. It comes down to an emphasis on the importance of implementation on an individual patient level, but also on an organizational level.”
Kittleson et al. (Thu,) conducted a review in Heart Failure. Clinical Performance and Quality Measures was evaluated. The 2024 ACC/AHA update introduces new performance measures for heart failure, including optimal blood pressure control in HFpEF, SGLT2 inhibitor use in HFrEF, and initiation of guideline-directed medical therapy during hospitalization.