The use of evidence-based, guideline-recommended therapies for heart failure can be associated with reduced risk of mortality over two years, with an incremental benefit observed with successive treatments, according to a new analysis of the IMPROVE-HF registry published in the Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. This study offers further evidence in support of adherence to evidence-based guidelines in heart failure patients in real-world settings, as well as more specific insight into efficacy of guideline-based therapies individually and in combination.
Adherence to (most) guideline-recommended HF therapies reduces risk of mortality
With programs running after new procedure volume, transcatheter aortic valve replacement (TAVR) has certainly been of interest among providers. Many programs have made early investments in hybrid operating rooms or expanded cath lab settings in order to accommodate this new technology. However, two primary obstacles to adoption of TAVR have been the lack of formal Medicare coverage and reimbursement criteria, as well as professional society-driven perspective on how—and who—should be appropriately utilizing the new procedure.
Fortunately, the Centers for Medicare & Medicaid Services (CMS) released a proposed coverage determination for TAVR, stipulating the device by approved for reimbursement under a “coverage with evidence development” (CED) policy. Not surprisingly, the conditions and criteria identified for coverage considerations closely follow the newly released ACCF/AATS/SCAI/STSS Expert Consensus Document, which detail the key clinical and programmatic elements for appropriate utilization of the procedure.
CMS proposes TAVR coverage, new consensus document released
A new analysis of the SPARC (Study of Myocardial Perfusion and Coronary Anatomy Imaging Roles in Coronary Artery Disease) Registry published in the Journal of the American College of Cardiology reveals that noninvasive cardiac imaging had only a modest impact on post-test patient management. These findings indicate both a need to reduce unnecessary imaging utilization, as well as more accurately incorporate test results into evidence-based care pathways.
Noninvasive cardiac imaging has limited impact on patient care in new study