The Treatment Gap in Coronary Artery Disease and Heart Failure: Community Standards and the Post-Discharge Patient

摘要: Abstract Progress in vascular biology, epidemiology, clinical trials, and cost-effectiveness analyses have allowed development of guidelines for risk reduction patients with disease congestive heart failure. However, these advances appear necessary but not sufficient to promote implementation treating coronary artery (CAD) failure (CHF). Evidence from the United Kingdom Europe, estimates States, suggest that a large “treatment gap” exists between recommended therapies cardiovascular care they are actually receiving. Despite known interventions proven efficacy reduce recurrence death CAD CHF, only minority receiving any intervention whatsoever. A second problem is that, among those care, many undertreated resulting very small number reaching goals levels therapy. Third, proportion at goal should be attainable (i.e., community standards) known. variety barriers exist preventive cardiology services. Although patient has chain opportunities reduction, it clear which links this (inpatient/hospital programs, specialist/generalist communication, ambulatory or compliance) major reason treatment gap. An ongoing project, American College Cardiology Evaluation Preventive Therapeutics (ACCEPT), will attempt quantify gap States try identify playing greatest role limiting optimal patient.