ACEI or ARB for LVSD

What It Means
The percentage of Heart failure patients with left ventricular systolic dysfunction (LVSD) who are prescribed either an ACE ((angiotensin converting enzyme inhibitor) or ARB (Angiotensin receptor blocker) at hospital discharge.

Why It Is Important
Clinical evidence shows that the use of an ACE or an ARB in patients improves long-term survival and provides greater benefit to the patient by reducing the risk of complications. ACE inhibitors and ARBs work by limiting the effects of a hormone that narrows blood vessels, and may thus lower blood pressure and reduce the work the heart has to perform. Since the ways in which these two kinds of drugs work are different, your doctor will decide which drug is most appropriate for you.

Numerator Definition
Patients with HF who are prescribed an ACE or an ARB at hospital discharge

Denominator Definition
Patients with HF that have left ventricular systolic dysfunction (LVSD) and without either an ACE or ARB contraindication.

Denominator Excluded Populations

  • Patients less than 18 years of age
  • Patients transferred to another acute care hospital
  • Patients who expired
  • Patients who left against medical advice
  • Patients discharged to hospice
  • Patients with chart documentation of participation in a clinical trial testing alternatives to ACE or ARB as first-line heart failure therapy
  • Patients with one or more of the following ACE or ARB contraindications/reasons for not prescribing documented in the medical record:
         -   ACE or ARB allergy;
         -   Moderate or severe aortic stenosis; or
         -   Other reasons documented by a physician, nurse practitioner, or physician assistant for not prescribing ACE or ARB at discharge

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