Methods:

The study cohort was comprised of Get With The Guidelines-HF study participants who were admitted for acute HF with reduced ejection fraction (HFrEF) between January 2005 and June 2014. They were stratified into three groups on the basis of their admission renal function: normal renal function, renal insufficiency without dialysis, and dialysis. In these three functional groups, the study authors evaluated temporal change in proportional adherence to the HF-related process of care measures and incidence of clinical outcomes (1-year mortality, HF hospitalization, and all-cause hospitalization). They obtained the data on mortality from Centers for Medicaid and Medicare Services (CMS) enrollment files, and hospitalization data were obtained from Part A inpatient claims files. They used the Cochran-Armitage trend test to compare temporal trends in adherence to the different HF process of care measures across the three groups. Multivariable Cox proportional hazards regression was performed to determine if there was a significant change in the risk of 1-year mortality, 1-year all-cause hospitalization, and 1-year HF-specific hospitalization over time.