{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:42:32Z","timestamp":1792424552007,"version":"4.5.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Despite strong evidence, adoption of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction remains suboptimal. The Get With The Guidelines\u2013Heart Failure (GWTG-HF) program was designed to close gaps in care. We evaluated whether hospital participation in GWTG-HF was associated with greater GDMT intensity and improved outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis (2013\u20132021) of Medicare beneficiaries with part A and part D hospitalized with heart failure with reduced ejection fraction. Using a multiple baseline time series design, we compared changes in GDMT and outcomes before and after GWTG-HF enrollment with hospitals that never participated. Coprimary outcomes were a 90-day postdischarge GDMT score under a parallel and nonparallel slopes model. Secondary outcomes included class-specific medication fills, achievement of \u226550% target doses, and 30-day, 90-day, and 1-year all-cause and HF readmission and mortality. Mortality and first HF readmission were also evaluated using Cox proportional hazards models. We adjusted for baseline hospital performance, patient characteristics, and temporal trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 1274\u2009863 Medicare beneficiaries hospitalized for heart failure with reduced ejection fraction, 53.5% were treated at hospitals that never participated in GWTG-HF and 9.6% at GWTG-HF hospitals. Unadjusted median GDMT scores increased from 3.0 in both groups to 4.0 in nonparticipating hospitals and 4.5 in GWTG-HF hospitals at 90 days (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Hospital enrollment was associated with a higher 90-day GDMT score (+0.15 points [95% CI, 0.12\u20130.20];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and greater use of \u03b2-blockers, renin-angiotensin system inhibitors, and mineralocorticoid receptor antagonists but not angiotensin receptor\u2013neprilysin inhibitors. GWTG-HF participation was associated with lower all-cause mortality at 30 days (odds ratio, 0.95 [95% CI, 0.92\u20130.98]) and 1 year (0.97 [95% CI, 0.949\u20130.995]; both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.05). Mortality differences were attenuated and no longer significant in the nonparallel slopes model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Hospital participation in GWTG-HF was associated with modest but significant improvements in postdischarge GDMT intensity, supporting the value of quality improvement initiatives to address persistent treatment gaps in heart failure with reduced ejection fraction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.126.014414","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T09:01:25Z","timestamp":1788339685000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Get With The Guidelines\u2013Heart Failure Hospital Participation and Its Association With Guideline-Directed Medical Therapy and Outcomes"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8877-2325","authenticated-orcid":true,"given":"Aradhana","family":"Verma","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Cardiovascular Institute, Stanford University School of Medicine, CA (A.V., P.H., A.S.V., J.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-8093","authenticated-orcid":true,"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles (G.C.F., N.B., A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7730-8490","authenticated-orcid":true,"given":"Paul","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Cardiovascular Institute, Stanford University School of Medicine, CA (A.V., P.H., A.S.V., J.F.)."},{"name":"Division of Cardiology, Veterans Affairs Palo Alto Health Care System, CA (P.H., J.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-3095","authenticated-orcid":true,"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Colorado, Aurora (L.A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4563-1071","authenticated-orcid":true,"given":"Andrew P.","family":"Ambrosy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center, CA (A.P.A.)."},{"name":"Division of Research, Kaiser Permanente San Francisco, Pleasanton, CA (A.P.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-2972","authenticated-orcid":true,"given":"Shun","family":"Kohsaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Shinjuku, Japan (S.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9697-8948","authenticated-orcid":true,"given":"Anubodh S.","family":"Varshney","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Cardiovascular Institute, Stanford University School of Medicine, CA (A.V., P.H., A.S.V., J.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8156-0808","authenticated-orcid":true,"given":"Nicholas","family":"Brownell","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles (G.C.F., N.B., A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Fan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Cardiovascular Institute, Stanford University School of Medicine, CA (A.V., P.H., A.S.V., J.F.)."},{"name":"Division of Cardiology, Veterans Affairs Palo Alto Health Care System, CA (P.H., J.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3208-1143","authenticated-orcid":true,"given":"Alexander T.","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles (G.C.F., N.B., A.T.S.)."},{"name":"Division of Cardiology, VA Greater Los Angeles Healthcare System, CA (A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000435779.48007.5c"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.hpc.0000243588.00012.79"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.125.012936"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.959122"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12511"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003567"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2007.03.020"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.122.008919"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2024.08.054"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001063"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.03.012"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.4324\/9780203771587"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeconom.2020.12.001"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.16.1813"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.0241"},{"key":"e_1_3_3_17_2","unstructured":"Anonymous. Rural Healthcare Outcomes Accelerator. Accessed February 18 2026. www.heart.org"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.5627"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.124.012547"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.126.014414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:13:12Z","timestamp":1792422792000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.126.014414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":18,"alternative-id":["10.1161\/CIRCHEARTFAILURE.126.014414"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.126.014414","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]},"assertion":[{"value":"2026-03-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e014414"}}