{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:47:01Z","timestamp":1790063221225,"version":"4.0.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T00:00:00Z","timestamp":1227916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The effectiveness of chronic heart failure (CHF) pharmacotherapy in unselected cohorts is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To estimate the association between quality of CHF pharmacotherapy and all-cause mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In a prospective cohort study, 1054 unselected patients with CHF (61% with reduced and 39% with normal left ventricular ejection fraction (LVEF)) were consecutively enrolled. Quality of pharmacotherapy was assessed by calculating a guideline adherence indicator (GAI-3, range 0\u2013100%) based on prescription of beta blockers, angiotensin converting enzyme inhibitors or angiotensin receptor II type-1 blockers, and mineralocorticoid receptor antagonists. Median follow-up in survivors was 595 days (100% complete). In patients with reduced LVEF the median GAI-3 was 67%, and inversely associated with age, CHF severity, and important comorbidities. Mortality rates in GAI-3 categories low\/medium\/high were 79\/30\/11 per 100 person-years. In multivariable Cox regression, high GAI-3 was independently predictive of lower mortality risk: hazard ratio (HR) 0.50 (95% confidence interval [CI] 0.32\u20130.74; P&amp;lt;0.001) vs low GAI-3. This association was also observed in subgroups of high age (HR 0.42, 95%CI 0.27\u20130.66; P&amp;lt;0.001) and women (HR 0.42, 95%CI 0.23\u20130.79; P=0.007).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this community-based cohort with CHF, better implementation of pharmacotherapy was associated with better prognosis in patients with reduced LVEF, irrespective of age and sex.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ejheart.2008.09.008","type":"journal-article","created":{"date-parts":[[2008,11,9]],"date-time":"2008-11-09T05:06:08Z","timestamp":1226207168000},"page":"1236-1245","source":"Crossref","is-referenced-by-count":63,"title":["Pharmacotherapy According to Treatment Guidelines is Associated with Lower Mortality in a Community-Based Sample of Patients with Chronic Heart Failure A Prospective Cohort Study"],"prefix":"10.1093","volume":"10","author":[{"given":"Stefan","family":"St\u00f6rk","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I\/Center for Cardiovascular Medicine, University of W\u00fcrzburg , Klinikstrasse 6-8, D-97070, W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Werner","family":"Hense","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Social Medicine, University of M\u00fcnster , Domagkstr. 3, D-48129, M\u00fcnster ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Zentgraf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\/Center for Cardiovascular Medicine, University of W\u00fcrzburg , Klinikstrasse 6-8, D-97070, W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Uebelacker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\/Center for Cardiovascular Medicine, University of W\u00fcrzburg , Klinikstrasse 6-8, D-97070, W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Jahns","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\/Center for Cardiovascular Medicine, University of W\u00fcrzburg , Klinikstrasse 6-8, D-97070, W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Ertl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\/Center for Cardiovascular Medicine, University of W\u00fcrzburg , Klinikstrasse 6-8, D-97070, W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane E.","family":"Angermann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I\/Center for Cardiovascular Medicine, University of W\u00fcrzburg , Klinikstrasse 6-8, D-97070, W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2008,11,29]]},"reference":[{"key":"2026020203410341700_ejhf2008-09-008-bib-0001","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1053\/euhj.2001.2783","article-title":"Guidelines for the diagnosis and treatment of chronic heart failure","volume":"22","author":"Remme","year":"2001","journal-title":"Eur Heart J"},{"key":"2026020203410341700_ejhf2008-09-008-bib-0002","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1093\/eurheartj\/ehi204","article-title":"Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): the task force for the diagnosis and treatment of chronic heart failure of the European society of cardiology","volume":"26","author":"Swedberg","year":"2005","journal-title":"Eur Heart J"},{"key":"2026020203410341700_ejhf2008-09-008-bib-0003","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jacc.2005.08.022","article-title":"ACC\/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure)","volume":"46","author":"Hunt","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2026020203410341700_ejhf2008-09-008-bib-0004","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S0195-668X(02)00700-5","article-title":"The EuroHeart Failure Survey programme \u2014 a survey on the quality of care among patients with heart failure in Europe. 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