{"id":"61fb2ff7627b","type":"article","url":"https://hartvaat.nl/2026/10/13/icare-hf-accreditatie-correleert-met-betere-richtlijntherapie-bij-hartfalen-gras/","title":"ICARe-HF-accreditatie correleert met betere richtlijntherapie bij hartfalen — GRASP-HF","title_en":"\"Baseline Characteristics and Utilization of Medical Therapies in Acute Hospitalized and Chronic Heart Failure Patients Enrolled in GRASP-HF: Differences Between ICARe-HF and Non-ICARe-HF Centres\".","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"European journal of heart failure","doi":"10.1093/ejhf/xuag317","source_url":"https://doi.org/10.1093/ejhf/xuag317","authors":["Ovidiu Chioncel","Gianluigi Savarese","Cecile Laroche","Offer Amir","Mariya Tokmakova","Mathilde Boutard","Antonio Cannata","Hamlet Hayrapetyan","Hans-Eckart Sarnighausen","Noha El Ouafi","Emilie Soriano","Brenda Moura","Lars Lund","Marianna Adamo","Wendy Guillouche","Maurizio Volterani","Bernard Iung","Wilfried Mullens","Marco Metra"],"significance":5,"published":"2026-10-21","source_date":"2026-10-13","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/esc-richtlijn-hartfalen-2021/","https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/"],"congress":"","summary_en":"The prospective GRASP-HF registry (n=10,936) compared guideline-directed medical therapy (GDMT) implementation between heart failure centres with and without ICARe-HF accreditation. Accredited centres showed significantly higher use of quadruple therapy (OR 1.73) and greater adoption of ARNIs and SGLT2 inhibitors, particularly in HFrEF. Although crude in-hospital mortality was lower in accredited centres, this association disappeared after multivariable adjustment. The findings highlight the potential of structured quality-improvement programmes to enhance contemporary GDMT delivery in routine practice.","created":"2026-10-14T01:23:58Z","updated":"2026-10-14T01:23:58Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De prospectieve GRASP-HF-cohortstudie (n=10.936) vergeleek de implementatie van richtlijntherapie tussen hartfalencentra met en zonder ICARe-HF-accreditatie. Centra met accreditatie gaven vaker quadruple therapy (OR 1,73) en gebruikten meer ARNI’s en SGLT2-remmers, vooral bij HFrEF. Hoewel de ruwe sterfelijkheid lager was, verdween dit verschil na correctie voor confounders. De bevindingen onderstrepen de meerwaarde van gestructureerde kwaliteitsprogramma’s voor het optimaliseren van medicamenteuze hartfalenbehandeling in de dagelijkse zorg.","abstract_original":"BACKGROUND: The Global Registries and Surveys Programme-Heart Failure (GRASP-HF) is a prospective, multicentre, international observational study assessing implementation of the 2021/2023 ESC-HF-Guidelines. GRASP-HF is aligned with the Improving Care through Accreditation and Recognition in Heart Failure (ICARe-HF) programme, which links centre-characteristics with guideline-implementation performance. AIMS: To compare baseline characteristics, guideline-directed-medical-therapy (GDMT) implementation, and in-hospital outcomes between GRASP-HF patients managed in centres participating or not participating in the ICARe-HF programme. METHODS: GRASP-HF patients were stratified by ICARe-HF participation, clinical settings, acute (AHF) vs chronic HF (CHF) and ejection fraction (EF) subtypes. Hierarchical multivariable logistic regression models evaluated associations with quadruple therapy implementation and in-hospital mortality. RESULTS: Among 10,936 patients (63.3% CHF, 36.7% AHF), patients from ICARe-HF participating centres (51.3%) were older, more comorbid but with less severe congestion. In both CHF and AHF, ICARe-HF centres demonstrated greater GDMT utilization, particularly angiotensin receptor-neprilysin inhibitors and sodium-glucose-cotransporter-2 inhibitors. In HFrEF, quadruple therapy was more frequently implemented (47% vs 40% in CHF; 27% vs 24% at AHF discharge) and remained associated with ICARe-HF participation after adjustment, Odd Ratio (OR) =1.73, 95% Confidence Interval (CI) :1.17-2.55. Target doses remained suboptimal, particularly after AHF. Although crude in-hospital mortality was lower in ICARe-HF centres (2.3% vs 5.5%), this association was attenuated after multivariable adjustment (OR=0.87, 95% CI:0.48-1.56). CONCLUSIONS: Participation in the ICARe-HF programme was associated with more comprehensive implementation of contemporary GDMT, particularly in HFrEF. The association with in-hospital mortality was attenuated after adjustment and should be considered exploratory."}