Implementation of the Get With The Guidelines‐Heart Failure Adherence to Science, Implementation in Asia (GWTG‐HF A.S.I.A.) Program in Taiwan
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background Guideline‐directed medical therapy (GDMT) improves outcomes in heart failure with reduced ejection fraction, yet its adoption across Asia remains suboptimal. The American Heart Association launched the GWTG‐HF A.S.I.A. (Get With The Guidelines‐Heart Failure Adherence to Science, Implementation in Asia) program in 2021. We examined the association between program participation and GDMT implementation in Taiwan. Methods We analyzed 1991 patients with heart failure with reduced ejection fraction enrolled in the Taiwan Society of Cardiology HF Registry (2021–2024). Four hospitals participated in the GWTG‐HF A.S.I.A. program (n=462) and 23 nonparticipating hospitals served as controls (n=1529). After propensity‐score matching, prescription trends of 4‐pillar GDMTs were compared using generalized estimating equations. Primary outcomes were patient‐level and hospital‐level GDMT prescription rates; secondary outcomes included echocardiographic remodeling, loss to follow‐up, and 2‐year mortality. Results Between 2021 and 2024, GDMT use increased in both groups, with greater gains in participating hospitals. Adjusted odds ratios (aOR) for program participation were 2.73 (95% CI, 2.23–3.34) for 4‐pillar GDMTs, 1.59 (95% CI, 1.31–1.92) for angiotensin receptor‐neprilysin inhibitors, 2.06 (95% CI, 1.72–2.47) for SGLT2 (sodium‐glucose co‐transporter 2) inhibitors, and 1.63 (95% CI, 1.34–2.00) for mineralocorticoid receptor antagonists (all P <0.001). After SGLT2 inhibitor reimbursement in 2022, the prescription gap widened. Participating hospitals showed greater left‐ventricular reverse remodeling and lower loss‐to‐follow‐up (0.5% versus 5.2%, P <0.001), and 2‐year mortality was similar. Conclusions Participation in the GWTG‐HF A.S.I.A. program was associated with higher GDMT prescription rates in Taiwanese hospitals. Structured quality improvement initiatives may help bridge the evidence‐practice gap in Asia.
Institutions: National Yang Ming Chiao Tung University, Cheng Hsin General Hospital, Chi Mei Medical Center, Stanford University, University of Colorado Anschutz, Taipei Veterans General Hospital, Min Sheng General Hospital, National Taiwan University Hospital, National Cheng Kung University Hospital, National Cheng Kung University, Taipei Medical University Hospital, Taipei Medical University, Far Eastern Memorial Hospital, Yuan Ze University
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,810
OpenAlex ID: W4417478952