Nationwide implementation of heart failure therapies - National Heart Failure Center Accreditation Program (HF-CAP) in China

Q: What study evaluated HF-CAP in China?

A prospective, longitudinal pre-post comparison evaluated nationwide multi-annual implementation of heart failure therapies in hospitals accredited by HF-CAP in China.

Q: How were patients grouped in the analysis?

Patients were divided into four time windows relative to accreditation: 6–12 months before (Pre), >0–≤12 months after (Y1), >12–≤24 months after (Y2), and >24 months after (Y2+).

Sep 29, 2026

Uploaded by Jasmine

Implementing optimal guideline-directed medical therapy remains challenging for patients with heart failure. This prospective longitudinal pre-post study evaluated large-scale, nationwide, multi-annual implementation of heart failure therapies in China among hospitals accredited by the National Heart Failure Center Accreditation Program (HF-CAP). Across 408,073 patients from 646 centres, accreditation increased adherence to discharge therapies and reduced 1-year composite heart failure readmission and/or cardiovascular death, with progressively lower risk after accreditation.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Keywords

Introduction

Methods and outcomes

European Journal of Heart Failure (2025) 27, 1964–1976 RESEARCH ARTICLE doi:10.1002/ejhf.70035 Nationwide implementation of heart failure therapies: National Heart Failure Center Accreditation Program (HF-CAP) in China Jingmin Zhou 1*, Xuejuan Jin2, Yamei Xu 1, Zhonglei Xie 1, Xiaotong Cui 1, Yanyan Wang 1, Hua Wang3, Xinli Li4, Yugang Dong5,6, Yuhua Liao7, Weimin Li8, Alexandre Mebazaa9 *, Jiefu Yang3 *, and Junbo Ge1*, on behalf of the Heart Failure Center Accreditation Program Investigators 1 Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China; 2 Department of Epidemiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China; 3 Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; 4 Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu, China; 5 Department of Cardiology, Center for Translational Medicine, Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 6 NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, China; 7 Department of Cardiology, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Hubei, China; 8 Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Heilongjiang, China; and 9 Université Paris Cité, Hôpitaux Universitaires Saint Louis Lariboisière, APHP, Paris, France Received 4 April 2025; revised 3 June 2025; accepted 14 August 2025 ; online publish-ahead-of-print 22 September 2025 Aims Implementing optimal guideline-directed medical therapy is still challenging in patients with heart failure (HF). This prospective study assessed the benefits of large-scale, nationwide, multi-annual implementation of HF therapies in China. ............................................................... ................................................................ ...................................... Methods This longitudinal, pre-post comparison design included patients in hospitals accredited by the National Heart Failure and results Center Accreditation Program (HF-CAP). Patients were divided into four groups: 6–12 months before accreditation (Pre); >0 –≤12 months after accreditation (Y1); > 12–≤24 months after accreditation (Y2), and >24 months after accreditation (Y2+). The primary endpoint was 1-year composite HF readmission and/or cardiovascular death. Secondary endpoints included 1-year HF readmission alone, 1-year cardiovascular death alone, and association between phone calls and/or visits and outcomes. Overall, 408 073 patients with HF from 646 centres were included. After HF-CAP accreditation, more patients with HF were treated following discharge. Compared with the Pre group, risk of meeting the primary endpoint decreased in Y1 and was incrementally lower in Y2 and Y2+: fully adjusted odds ratios (OR) and 95% confidence intervals (CIs) were 0.893 (0.871–0.916), 0.855 (0.830–0.880) and 0.720 (0.695–0.745), respectively (all p < 0.0001). Risk of HF readmission alone reduced from Y 1 onwards (OR 0.865 [95% CI 0.841–0.891]). Risk of cardiovascular death reduced from Y2 onwards (OR 0.942 [95% CI 0.904–0.983]). Phone calls had little association with patient outcomes; however, face-to-face visits reduced risk of cardiovascular death (OR 0.624 [95% CI 0.597–0.651]). ............................................................... ................................................................ ...................................... Conclusions Guideline-directed medical therapy implementation and follow-up after HF hospitalization was achievable in ∼400 000 patients and was associated with cardiovascular benefits 1-year post-initiation. .......................

FAQs

What study evaluated HF-CAP in China?

A prospective, longitudinal pre-post comparison evaluated nationwide multi-annual implementation of heart failure therapies in hospitals accredited by HF-CAP in China.

How were patients grouped in the analysis?

Patients were divided into four time windows relative to accreditation: 6–12 months before (Pre), >0–≤12 months after (Y1), >12–≤24 months after (Y2), and >24 months after (Y2+).

Which outcomes improved after HF-CAP accreditation?

After accreditation, the primary composite endpoint decreased, and heart failure readmission alone declined from Y1 onward, while cardiovascular death alone decreased from Y2 onward; face-to-face visits were associated with lower cardiovascular death risk.

Sep 29, 2026

Uploaded by Jasmine