CHAMP

Program Results
To assess the impact of the program, treatment rates and clinical outcome were compared in patients discharged after myocardial infarction in the 2 year period before (1992-1993) and the 2 year period after (1994-1995) CHAMP was implemented. In the pre and post CHAMP patient groups, aspirin utilization rates at discharge improved from 68% to 92% (p<0.01), beta blocker utilization improved from 12% to 62% (p<0.01), ACE inhibitor utilization from 6% to 58% (p<0.01), and statin utilization from 6% to 86% (p<0.01). These treatment rates at the time of hospital discharge represent among the highest overall treatment rates ever reported.

This increased treatment utilization persisted during subsequent follow-up. At one year, after hospital discharge 91% of patients were on statin treatment. The treatment rates for beta blockers, ACE inhibitors, and aspirin also remained high. The CHAMP study demonstrated for the first time that hospital based initiation of lipid lowering therapy markedly improves patient compliance with treatment. Further evidence of improved treatment was provided in that there was a significant increase in patient achieving an LDL cholesterol < 100 mg/dl (6% vs 58%, p<0.001).
Marked Impact on Clinical Outcomes

The improvement in treatment rates had dramatic impact on clinical outcomes for patients CHAMP was associated with a marked 57% reduction in the risk of recurrent myocardial infarction and mortality in the first year after hospital discharge. There was also a significant reduction in hospitalization. Thus CHAMP reduced health care costs while at the same time saving lives.
  

 

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Clinical Significance  

This study demonstrates that coronary artery disease risk factor modification and treatment can be systematically integrated into the treatment provided during cardiac hospitalizations without additional resources or medical personnel. This approach appears to be considerably more effective than the use of conventional guidelines and care.

 

Widespread application of CHAMP or other hospital based treatment protocols could dramatically effect coronary artery treatment rates with proven cost effective therapies and thus substantially reduce the risk of future coronary events and prolong life in the large number of patients hospitalized each year with coronary artery disease.

 

In 1998, 1,263,000 males and 915,000 females diagnosed with coronary heart disease were discharged from hospitals. Increasing the implementation of secondary prevention medical therapies though the use of hospital based programs such as CHAMP would result in tens of thousand of additional lives saved.

There are 5000 acute care hospitals in the United States but only a few have programs in place to ensure cardiac patients are treated with secondary prevention measures.