Hospitalized heart failure patients in the United States are living longer and receiving more optimized evidence-based care, according to new research drawn from nearly two decades of data in the American Heart Association's Get With The Guidelines® - Heart Failure registry.
Launched in 2005, the Get With The Guidelines - Heart Failure program was created to improve care for people hospitalized with heart failure, a condition that led to the death of about one in three patients within a year.
Today, more than 600 hospitals across the country are part of this effort to save lives. The program has helped close persistent care gaps through data-driven benchmarking, hospital toolkits, workshops, webinars and recognition programs, all aimed at accelerating adoption of evidence-based guideline-recommended therapies.
"The Get With The Guidelines program continues to be a cornerstone for improving heart failure care," said Sabra Lewsey, M.D., MPH, volunteer chair of the American Heart Association's Heart Failure Systems of Care Committee and assistant professor of medicine at Johns Hopkins Medicine. "Its impact on long-term survival demonstrates how quality improvement efforts can transform patient trajectories."
The research manuscript, published in Circulation: Heart Failure, details how hospitals engaged in the program consistently outperform peers on heart failure process measures and patient outcomes, even after adjusting for variables like hospital size and geographic region. Notably, lower 30-day risk-standardized mortality rates at participating hospitals correlate with significantly better long-term survival for people with heart failure.
Insights from the program have helped shape modern understanding of the disease. Among other findings, Get With The Guidelines - Heart Failure data challenged longstanding assumptions that individuals with preserved left ventricular ejection fraction had more favorable prognoses — a discovery that spurred new lines of clinical investigation and public health strategy.
Despite measurable progress, challenges remain.
"Heart failure mortality is still too high, and far too few people receive the full benefit of available, evidence-based therapies," said Gregg Fonarow, M.D., FAHA, longtime American Heart Association volunteer who helped to establish the program. Fonarow is also interim chief of the division of cardiology, director of the Ahmanson-UCLA Cardiomyopathy Center, co-director of the Preventative Cardiology Program and the Eliot Corday Chair in Cardiovascular Medicine and Science at the University of California, Los Angeles. "This legacy quality improvement program improves the health care landscape for heart failure and serves as a guidepost for other cardiovascular and stroke conditions."
The research authors note that Get With The Guidelines - Heart Failure registry remains a robust engine for future research, now with more than 170 peer-reviewed publications, nearly half of which appear in high-impact journals.
"This program is no longer a data repository but a nexus for outcomes sciences, data science, and implementation science, all of which now drive innovations in personalized care, inform national policy, and strengthen hospital systems across the country," said Clyde W. Yancy, M.D., M.Sc., FAHA, past volunteer president of the American Heart Association (2009–2010) and chief of cardiology in the department of medicine at Northwestern University's Feinberg School of Medicine, in Chicago. Yancy was also instrumental is championing the development of the Get With The Guidelines program.
