2022
Survival Probability and Survival Benefit Associated With Primary Prevention Implantable Cardioverter‐Defibrillator Generator Changes
Bilchick KC, Wang Y, Curtis JP, Shadman R, Dardas TF, Anand I, Lund LH, Dahlström U, Sartipy U, Levy WC. Survival Probability and Survival Benefit Associated With Primary Prevention Implantable Cardioverter‐Defibrillator Generator Changes. Journal Of The American Heart Association 2022, 11: e023743. PMID: 35766293, PMCID: PMC9333379, DOI: 10.1161/jaha.121.023743.Peer-Reviewed Original ResearchConceptsSeattle Heart Failure ModelHeart failure modelHeart failure patientsResynchronization therapyGenerator changeSurvival benefitWorse survivalFailure patientsNational Cardiovascular Data Registry ICD RegistryGC survivalSurvival Benefit AssociatedPrimary prevention indicationVentricular ejection fractionAnnual mortalityICD therapyConclusions PatientsPrevention indicationEjection fractionICD RegistryImproved survivalPrimary preventionPatient deathGreater effect sizeLVEFPatientsLongitudinal Outcomes of Subcutaneous or Transvenous Implantable Cardioverter-Defibrillators in Older Patients
Friedman DJ, Qin L, Parzynski C, Heist EK, Russo AM, Ranasinghe I, Zeitler EP, Minges KE, Akar JG, Freeman JV, Curtis JP, Al-Khatib SM. Longitudinal Outcomes of Subcutaneous or Transvenous Implantable Cardioverter-Defibrillators in Older Patients. Journal Of The American College Of Cardiology 2022, 79: 1050-1059. PMID: 35300816, DOI: 10.1016/j.jacc.2021.12.033.Peer-Reviewed Original ResearchMeSH KeywordsAgedArrhythmias, CardiacDeath, Sudden, CardiacDefibrillators, ImplantableFemaleHumansMaleMedicareRetrospective StudiesTreatment OutcomeUnited StatesConceptsOlder patientsCause readmissionS-ICDNational Cardiovascular Data Registry ICD RegistryDevice removalTransvenous implantable cardioverter defibrillatorTV-ICD patientsRisk of deathS-ICD patientsService Medicare beneficiariesAnderson-Gill modelsImplantable cardioverter defibrillatorRepresentative national cohortCompeting-risks modelTV-ICDCardiovascular readmissionCause mortalityICD implantationYounger patientsICD RegistryNonfatal outcomesTransvenous ICDAtrial fibrillationNational cohortCardioverter defibrillator
2021
Risk and predictors of mortality after implantable cardioverter-defibrillator implantation in patients with sarcoid cardiomyopathy
Higgins AY, Annapureddy AR, Wang Y, Minges KE, Bellumkonda L, Lampert R, Rosenfeld LE, Jacoby DL, Curtis JP, Miller EJ, Freeman JV. Risk and predictors of mortality after implantable cardioverter-defibrillator implantation in patients with sarcoid cardiomyopathy. American Heart Journal 2021, 246: 21-31. PMID: 34968442, DOI: 10.1016/j.ahj.2021.12.011.Peer-Reviewed Original ResearchConceptsNon-ischemic cardiomyopathyAtrial fibrillation/flutterChronic lung diseaseCardiac sarcoidosisHeart failureCS patientsNICM patientsICD implantationLung diseaseNew York Heart Association class III heart failureNational Cardiovascular Data Registry ICD RegistryNYHA class IV heart failureClass III heart failureClass IV heart failureImplantable cardioverter defibrillator implantationKaplan-Meier survival curvesCox proportional hazards modelPredictors of mortalityCardioverter-defibrillator implantationVentricular ejection fractionMultivariable logistic regressionPrior ventricular arrhythmiasProportional hazards modelRate of deathTime of implantationTrends in ICD Implantations and in-Hospital Outcomes After DOJ Investigation
Bourdillon PM, Parzynski CS, Minges KE, Curtis JP, Desai NR. Trends in ICD Implantations and in-Hospital Outcomes After DOJ Investigation. Journal Of Cardiac Failure 2021, 28: 154-160. PMID: 34628015, DOI: 10.1016/j.cardfail.2021.09.010.Peer-Reviewed Original ResearchMeSH KeywordsAgedDeath, Sudden, CardiacDefibrillators, ImplantableHeart FailureHospitalsHumansMedicareMyocardial InfarctionPrimary PreventionRegistriesUnited StatesConceptsHospital adverse eventsHospital outcomesAdverse eventsHeart failureMyocardial infarctionRecent acute myocardial infarctionPlacement of ICDsPrimary prevention ICDsAdverse event ratesRecent myocardial infarctionAcute myocardial infarctionHigh mortality rateICD implantationRecent diagnosisMortality ratePatientsICDInfarctionHospitalOutcomesRapid reductionUse of devicesFailureSpecific reasonsCriteriaLongitudinal Outcomes Associated With Non-Evidence-Based Implantable Cardioverter-Defibrillators Among Medicare Beneficiaries (From the National Cardiovascular Data Registry)
Daimee UA, Aslam F, Parzynski CS, Desai NR, Curtis JP. Longitudinal Outcomes Associated With Non-Evidence-Based Implantable Cardioverter-Defibrillators Among Medicare Beneficiaries (From the National Cardiovascular Data Registry). The American Journal Of Cardiology 2021, 155: 64-71. PMID: 34315569, DOI: 10.1016/j.amjcard.2021.06.020.Peer-Reviewed Original ResearchConceptsPrimary prevention ICD implantationRisk of mortalityICD implantationHeart failureICD RegistryMortality riskNational Cardiovascular Data Registry ICD RegistryPivotal randomized clinical trialsHospital adverse eventsSevere heart failureRecent myocardial infarctionCause hospital readmissionRandomized clinical trialsSimilar mortality riskLongitudinal outcomesImplantable cardioverter defibrillatorGreater mortality riskCause hospitalizationCause mortalityCoronary revascularizationAdverse eventsHospital readmissionICD recipientsDevice implantationPrimary preventionImpact of insurance status on ICD implantation practice patterns: Insights from the NCDR ICD registry
Ahmed I, Merchant FM, Curtis JP, Parzynski CS, Lampert R. Impact of insurance status on ICD implantation practice patterns: Insights from the NCDR ICD registry. American Heart Journal 2021, 235: 44-53. PMID: 33503408, DOI: 10.1016/j.ahj.2021.01.016.Peer-Reviewed Original ResearchMeSH KeywordsDeath, Sudden, CardiacDefibrillators, ImplantableFemaleHeart FailureHumansInsurance CoverageMaleMiddle AgedPrimary PreventionRegistriesRetrospective StudiesConceptsOptimal medical therapyInsurance statusNCDR ICD RegistryMedical therapyComplication rateICD RegistryUninsured patientsCardiac resynchronization therapy defibrillatorPrivate insurancePropensity-weighted analysisSingle-chamber devicesPrimary preventionMean ageICD implantsPractice patternsTreatment weightingImplantation practicePatientsInverse probabilityTherapyInsurance coverageFurther studiesRegistryMedicareStatus
2020
Periprocedural Risk and Survival Associated With Implantable Cardioverter-Defibrillator Placement in Older Patients With Advanced Heart Failure
Fudim M, Ali-Ahmed F, Parzynski CS, Ambrosy AP, Friedman DJ, Pokorney SD, Curtis JP, Fonarow GC, Masoudi FA, Hernandez AF, Al-Khatib SM. Periprocedural Risk and Survival Associated With Implantable Cardioverter-Defibrillator Placement in Older Patients With Advanced Heart Failure. JAMA Cardiology 2020, 5: 643-651. PMID: 32211811, PMCID: PMC7097837, DOI: 10.1001/jamacardio.2020.0391.Peer-Reviewed Original ResearchConceptsAdvanced heart failureAdvanced HF populationHeart transplant listingPeriprocedural complication rateHeart failureSudden cardiac deathComparator groupVentricular assist deviceInotrope useTransplant listingCardiac deathComplication rateHF populationPrimary preventionCardiac arrestNew York Heart Association class IV symptomsNational Cardiovascular Data Registry ICD RegistryAssist deviceLeft ventricular ejection fractionImplantable cardioverter-defibrillator placementAdvanced HF groupClass IV symptomsFirst-time ICDLeft ventricular assist deviceNYHA class II
2019
Modeling defibrillation benefit for survival among cardiac resynchronization therapy defibrillator recipients
Bilchick KC, Wang Y, Curtis JP, Cheng A, Dharmarajan K, Shadman R, Dardas TF, Anand I, Lund LH, Dahlström U, Sartipy U, Maggioni A, O'Connor C, Levy WC. Modeling defibrillation benefit for survival among cardiac resynchronization therapy defibrillator recipients. American Heart Journal 2019, 222: 93-104. PMID: 32032927, PMCID: PMC7814502, DOI: 10.1016/j.ahj.2019.12.017.Peer-Reviewed Original ResearchConceptsCRT-D patientsImplantable cardioverter defibrillatorSurvival benefitCRT-DsCardiac resynchronization therapy defibrillator recipientsCardiac resynchronization therapy candidatesSeattle Heart Failure ModelSeattle Proportional Risk ModelCox proportional hazards regressionNational Cardiovascular Data RegistryHeart Failure TrialHeart failure patientsProportional hazards regressionHeart failure modelProportional risk modelFailure patientsCRT candidatesHeart failureCRT pacemakerFailure TrialArrhythmic deathHazards regressionDefibrillator recipientsCRT deviceCardioverter defibrillatorOutcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database
Hummel JP, Leipold RJ, Amorosi SL, Bao H, Deger KA, Jones PW, Kansal AR, Ott LS, Stern S, Stein K, Curtis JP, Akar JG. Outcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database. Journal Of Cardiovascular Electrophysiology 2019, 30: 1066-1077. PMID: 30938894, PMCID: PMC6850124, DOI: 10.1111/jce.13934.Peer-Reviewed Original ResearchAgedAged, 80 and overArrhythmias, CardiacCost-Benefit AnalysisDatabases, FactualDeath, Sudden, CardiacDefibrillators, ImplantableElectric CountershockFemaleHealth Care CostsHumansMaleMedicareModels, EconomicPatient ReadmissionPredictive Value of TestsQuality-Adjusted Life YearsRegistriesRemote Sensing TechnologyTelemetryTime FactorsTreatment OutcomeUnited States
2017
Long-term morbidity and mortality after implantable cardioverter-defibrillator implantation with procedural complication: A report from the National Cardiovascular Data Registry
Kipp R, Hsu JC, Freeman J, Curtis J, Bao H, Hoffmayer KS. Long-term morbidity and mortality after implantable cardioverter-defibrillator implantation with procedural complication: A report from the National Cardiovascular Data Registry. Heart Rhythm 2017, 15: 847-854. PMID: 28987459, DOI: 10.1016/j.hrthm.2017.09.043.Peer-Reviewed Original ResearchConceptsCause mortalityMedicare beneficiariesICD implantationProcedural complicationsHospital characteristicsMultivariable Cox proportional hazards regression analysisNational Cardiovascular Data Registry ICD RegistryCox proportional hazards regression analysisFirst-time ICD recipientsImplantable cardioverter defibrillator implantationNational Cardiovascular Data RegistryProportional hazards regression analysisKaplan-Meier survival analysisLong-term morbidityPredictors of mortalityCardioverter-defibrillator implantationOccurrence of complicationsRetrospective registry studyAcute procedural complicationsHazards regression analysisLong-term outcomesRisk of mortalityMortality 3 yearsIndex hospitalizationRegistry studyComplications Associated With Implantable Cardioverter Defibrillators in Adults With Congenital Heart Disease or Left Ventricular Noncompaction Cardiomyopathy (From the NCDR® Implantable Cardioverter-Defibrillator Registry)
Gleva MJ, Wang Y, Curtis JP, Berul CI, Huddleston CB, Poole JE. Complications Associated With Implantable Cardioverter Defibrillators in Adults With Congenital Heart Disease or Left Ventricular Noncompaction Cardiomyopathy (From the NCDR® Implantable Cardioverter-Defibrillator Registry). The American Journal Of Cardiology 2017, 120: 1891-1898. PMID: 28917495, DOI: 10.1016/j.amjcard.2017.07.103.Peer-Reviewed Original ResearchConceptsCongenital heart diseaseComplication rateVentricular noncompaction cardiomyopathyHeart diseaseHospital complicationsEbstein's anomalyCardiac resynchronizationSeptal defectNoncompaction cardiomyopathyImplantable cardioverter defibrillator implantationDual chamberAcute lead dislodgmentsSingle-chamber ICDCardioverter-defibrillator implantationPeriprocedural complication rateGreater complication rateVentricular septal defectTetralogy of FallotAtrial septal defectImplantable cardioverter defibrillatorChildhood heart diseaseSingle-chamber devicesChi-square testHospital deathAdult patientsSeattle Heart Failure and Proportional Risk Models Predict Benefit From Implantable Cardioverter-Defibrillators
Bilchick KC, Wang Y, Cheng A, Curtis JP, Dharmarajan K, Stukenborg GJ, Shadman R, Anand I, Lund LH, Dahlström U, Sartipy U, Maggioni A, Swedberg K, O’Conner C, Levy WC. Seattle Heart Failure and Proportional Risk Models Predict Benefit From Implantable Cardioverter-Defibrillators. Journal Of The American College Of Cardiology 2017, 69: 2606-2618. PMID: 28545633, PMCID: PMC5502749, DOI: 10.1016/j.jacc.2017.03.568.Peer-Reviewed Original ResearchConceptsSeattle Heart Failure ModelSeattle Proportional Risk ModelNational Cardiovascular Data RegistryPrimary prevention ICDsHeart failureSudden deathCause mortalitySurvival benefitMultivariable Cox proportional hazards regressionCox proportional hazards regressionProportional riskProportional hazards regressionRecent clinical trialsHeart failure modelProportional risk modelControl patientsOverall survivalVentricular arrhythmiasHazards regressionICD benefitClinical trialsCardioverter defibrillatorLarge cohortHigh riskData registryAddition of Blood Pressure and Weight Transmissions to Standard Remote Monitoring of Implantable Defibrillators and its Association with Mortality and Rehospitalization
Al-Chekakie MO, Bao H, Jones PW, Stein KM, Marzec L, Varosy PD, Masoudi FA, Curtis JP, Akar JG. Addition of Blood Pressure and Weight Transmissions to Standard Remote Monitoring of Implantable Defibrillators and its Association with Mortality and Rehospitalization. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003087. PMID: 28506978, DOI: 10.1161/circoutcomes.116.003087.Peer-Reviewed Original ResearchConceptsBlood pressure dataImplantable defibrillatorsRemote patient monitoringTransmission of weightHeart failure hospitalizationImpaired ejection fractionCardiac resynchronization therapyCox regression modelRisk of mortalityLogistic regression modelsRoutine weightCause hospitalizationFailure hospitalizationBlood pressureCardiovascular hospitalizationEjection fractionResynchronization therapyRegression modelsDevice implantationService patientsHospital characteristicsIndependent associationImproved outcomesLandmark analysisSimilar risk
2015
Use of Remote Monitoring Is Associated With Lower Risk of Adverse Outcomes Among Patients With Implanted Cardiac Defibrillators
Akar JG, Bao H, Jones PW, Wang Y, Varosy PD, Masoudi FA, Stein KM, Saxon LA, Normand SL, Curtis JP. Use of Remote Monitoring Is Associated With Lower Risk of Adverse Outcomes Among Patients With Implanted Cardiac Defibrillators. Circulation Arrhythmia And Electrophysiology 2015, 8: 1173-1180. PMID: 26092577, DOI: 10.1161/circep.114.003030.Peer-Reviewed Original ResearchConceptsImplantable cardioverter defibrillatorInitial implantable cardioverter defibrillatorCause mortalityLower riskAdverse outcomesNational Cardiovascular Data Registry ICD RegistryRemote patient monitoringSocial Security Death Master FileCause rehospitalization rateRisk of rehospitalizationImplanted cardiac defibrillatorsDeath Master FileCardiomyopathy pathogenesisCause rehospitalizationICD RegistryRehospitalization ratesMultivariable analysisStudy cohortVital statusService patientsCardioverter defibrillatorCox modelMedicare populationMedicare feePatientsDefibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry
Kaiser DW, Tsai V, Heidenreich PA, Goldstein MK, Wang Y, Curtis J, Turakhia MP, Registry C. Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry. Heart Rhythm 2015, 12: 2086-2093. PMID: 25982720, PMCID: PMC4770888, DOI: 10.1016/j.hrthm.2015.05.010.Peer-Reviewed Original ResearchConceptsMulticenter Unsustained Tachycardia TrialMulticenter Automatic Defibrillator Implantation TrialICD RegistryPrimary preventionICD implantationInclusion criteriaNational Cardiovascular Data Registry ICD RegistryMultivariate analysisImplantable cardioverter defibrillator implantationAtrioventricular conduction diseaseFirst-time ICDPrimary prevention ICDsPrior cardiac transplantationHeart Failure TrialPrimary prevention trialsProportion of patientsCardioverter-defibrillator implantationAppropriate use criteriaSudden cardiac deathCardiac transplantationDefibrillator implantationMADIT-IIPatient characteristicsYounger patientsCardiac deathGender and outcomes after primary prevention implantable cardioverter-defibrillator implantation: Findings from the National Cardiovascular Data Registry (NCDR)
Russo AM, Daugherty SL, Masoudi FA, Wang Y, Curtis J, Lampert R. Gender and outcomes after primary prevention implantable cardioverter-defibrillator implantation: Findings from the National Cardiovascular Data Registry (NCDR). American Heart Journal 2015, 170: 330-338. PMID: 26299231, PMCID: PMC4768728, DOI: 10.1016/j.ahj.2015.02.025.Peer-Reviewed Original ResearchConceptsNational Cardiovascular Data RegistryPrimary preventionHF readmissionCause readmissionHospital dischargeICD implantationHeart failurePrimary prevention implantable cardioverter-defibrillator (ICD) implantationDual-chamber ICD implantationImplantable cardioverter defibrillator implantationPatients 65 yearsAdvanced heart failureProcedure-related complicationsCardioverter-defibrillator implantationDevice-related complicationsSudden cardiac deathHigh-risk individualsDual-chamber ICDGreater comorbidityBaseline characteristicsOlder patientsCardiac deathProcedural complicationsWorse outcomesClinical trialsA validated risk model for 1-year mortality after primary prevention implantable cardioverter defibrillator placement
Heidenreich PA, Tsai V, Curtis J, Wang Y, Turakhia MP, Masoudi FA, Varosy PD, Goldstein MK. A validated risk model for 1-year mortality after primary prevention implantable cardioverter defibrillator placement. American Heart Journal 2015, 170: 281-289.e2. PMID: 26299225, DOI: 10.1016/j.ahj.2014.12.013.Peer-Reviewed Original ResearchConceptsOne-year mortalityImplantable cardioverter defibrillatorRisk factorsHeart failurePrimary preventionMortality riskRisk scorePrimary prevention implantable cardioverter-defibrillator placementB-type natriuretic peptide valuesImplantable cardioverter-defibrillator placementCardiovascular Disease RegistryPrimary prevention populationNatriuretic peptide valuesChronic lung diseaseSystolic blood pressureSimilar risk factorsBlood urea nitrogenPg/mLLogistic regression modelsPrevention populationICD therapyICD implantationBlood pressureICD RegistryICD placement
2014
Implant and Clinical Characteristics for Pediatric and Congenital Heart Patients in the National Cardiovascular Data Registry Implantable Cardioverter Defibrillator Registry
Jordan CP, Freedenberg V, Wang Y, Curtis JP, Gleva MJ, Berul CI. Implant and Clinical Characteristics for Pediatric and Congenital Heart Patients in the National Cardiovascular Data Registry Implantable Cardioverter Defibrillator Registry. Circulation Arrhythmia And Electrophysiology 2014, 7: 1092-1100. PMID: 25287482, DOI: 10.1161/circep.114.001841.Peer-Reviewed Original ResearchConceptsNew York Heart Association classPrimary preventionSecondary preventionPediatric patientsAssociation classLEAD patientsGreat vesselsNational Cardiovascular Data Registry Implantable Cardioverter Defibrillator RegistryHigher New York Heart Association classImplantable Cardioverter-Defibrillator RegistryImplantable cardioverter defibrillator implantationNational Cardiovascular Data RegistryImplantable cardioverter-defibrillator indicationsImplantable cardioverter-defibrillator (ICD) proceduresCongenital heart patientsCardioverter-defibrillator implantationStructural heart diseaseHigh rateLead implantsOverall registryVentricle patientsClinical characteristicsDefibrillator implantationCHD typesCommon ventricleSurvival After Primary Prevention Implantable Cardioverter-Defibrillator Placement Among Patients With Chronic Kidney Disease
Hess PL, Hellkamp AS, Peterson ED, Sanders GD, Al-Khalidi HR, Curtis LH, Hammill BG, Pun PH, Curtis JP, Anstrom KJ, Hammill SC, Al-Khatib SM. Survival After Primary Prevention Implantable Cardioverter-Defibrillator Placement Among Patients With Chronic Kidney Disease. Circulation Arrhythmia And Electrophysiology 2014, 7: 793-799. PMID: 25038119, PMCID: PMC4206571, DOI: 10.1161/circep.114.001455.Peer-Reviewed Original ResearchMeSH KeywordsAgedCause of DeathChi-Square DistributionComorbidityDeath, Sudden, CardiacDefibrillators, ImplantableElectric CountershockFemaleGlomerular Filtration RateHeart FailureHumansKaplan-Meier EstimateKidneyLinear ModelsMaleMiddle AgedMultivariate AnalysisPatient SelectionPrimary PreventionProportional Hazards ModelsProsthesis DesignRegistriesRenal Insufficiency, ChronicRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsTreatment OutcomeUnited StatesConceptsChronic kidney diseasePrimary prevention ICD placementRisk of deathICD placementCKD severityKidney diseaseNational Cardiovascular Data Registry ICD RegistryPrimary prevention implantable cardioverter-defibrillator placementGlomerular filtration rate 30Implantable cardioverter-defibrillator candidatesEnd-stage renal diseaseImplantable cardioverter-defibrillator placementSocial Security Death Master FileHeart failure symptomsLow ejection fractionGlomerular filtration rateRate of deathDeath Master FileICD candidacyCKD stageDiabetes mellitusEjection fractionICD RegistryRenal diseaseSerum sodiumPrevalence of Guideline-Directed Medical Therapy Among Patients Receiving Cardiac Resynchronization Therapy Defibrillator Implantation in the National Cardiovascular Data Registry During the Years 2006 to 2008
Schneider PM, Pellegrini CN, Wang Y, Fein AS, Reynolds MR, Curtis JP, Masoudi FA, Varosy PD. Prevalence of Guideline-Directed Medical Therapy Among Patients Receiving Cardiac Resynchronization Therapy Defibrillator Implantation in the National Cardiovascular Data Registry During the Years 2006 to 2008. The American Journal Of Cardiology 2014, 113: 2052-2056. PMID: 24793671, PMCID: PMC4346333, DOI: 10.1016/j.amjcard.2014.03.049.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAged, 80 and overAngiotensin-Converting Enzyme InhibitorsCardiac Resynchronization TherapyCombined Modality TherapyDeath, Sudden, CardiacDefibrillators, ImplantableFemaleFollow-Up StudiesHeart FailureHumansMaleMiddle AgedPractice Guidelines as TopicPrevalenceRegistriesRetrospective StudiesRisk AssessmentSurvival AnalysisTreatment OutcomeUnited StatesVentricular Dysfunction, LeftConceptsGuideline-directed medical therapyCardiac resynchronization therapyImplantable Cardioverter-Defibrillator RegistryAngiotensin II receptor inhibitorΒ-blockersMedical therapyClass IReceptor inhibitorsNational Cardiovascular Data Registry Implantable Cardioverter Defibrillator RegistryCardiac resynchronization therapy defibrillator implantationLeft ventricular systolic dysfunctionSevere heart failure symptomsAngiotensin-converting enzyme inhibitorNational Cardiovascular Data RegistryClass I indicationsCRT-D implantationHeart failure symptomsVentricular systolic dysfunctionProportion of patientsSelection of patientsReal-world patientsAngiotensin-converting enzymePrevalence of guidelinesContemporaneous guidelinesQuality improvement targets