There are few data about predictors of cardiovascular mortality and rehospitalization rate in patients with left ventricular systolic dysfunction (LVSD) after myocardial revascularization and optimization of pharmacological treatment.

Background In recent years, the incidence of systolic heart failure has increased. Besides a complete revascularization, guideline-based medication represents the most effective therapeutic approach. Aim Analysis of adherence of guideline-recommended and actual medication during inpatient cardiac rehabilitation as well as under subsequent outpatient conditions. Methods From 01/1998 to 12/ 2000, 1346 consecutive patients (64 +/- 10 years, 73% male, LVEF 36.3 +/- 8%, 88% ischemic, 6.7% valvular cardiomyopathy, 5.3% other causes, 11.8% atrial fibrillation) were included in a single-center prospective register. Medication was recorded at discharge and after the follow-up period of 731 +/- 215 days. Trends in prescription rates were analyzed based on nonparametric correlations (Spearman's-Rho). Changes in medication from in- to outpatient settings were analyzed using exact McNemar test. Results At discharge 75.3% (67.9%/68.9%/ 86.6% in 1998/1999/2000, p < 0.001) of the patients were treated as recommended. This rate dropped to 68.3% at follow-up (p < 0.0001). Mortality within the follow-up period was low (12.6%). Conclusion It could be shown that from 1998 to 2000 inpatient guideline conformity was implementable adequately. Outpatient conformity was significantly lower. Although a high proportion of correctly prescribed CHF medication could be demonstrated, a further effort to im prove guideline adherence in the management of heart failure patients is desirable.

was Ͼ20 genome-equivalents per milliliter, and the amount of circulating DNA in maternal plasma would be sufficient to analyze fetal gender.In conclusion, this is the first description of the diagnostic accuracy of fetal gender determination from a large number of maternal plasma samples obtained at early gestation.Because this test is noninvasive and highly accurate, it can be used as a valuable first step in various clinical settings.