OBJECTIVES : Left ventricular ejection fraction (LVEF) is an important indicator of heart function in at-risk cardiac patients. Measurement of LVEF may be used to optimize medication treatment for patients with coronary artery disease (CAD), hypertension, and atrial fibrillation and to evaluate physician quality performance measures. In this study, documentation of left ventricular ejection fraction (LVEF) in the cardiovascular PINNACLE Registry® was compared with three general-purpose electronic health records (EHR1, EHR2, and EHR3).

METHODS : Eligible patients were those with at least one outpatient encounter in the time period from April 1, 2014 to March 31, 2019, with a diagnosis of CAD, hypertension, or atrial fibrillation.

RESULTS : In the PINNACLE registry, 3,425,596 patients of 8,012,174 eligible patients (42.8%) had an LVEF recorded. In EHR1, 142,408 patients of 1,261,137 eligible patients (11.3%) had an LVEF recorded; in EHR2, 59,843 patients of 1,800,394 eligible patients (3.3%) had an LVEF recorded; and in EHR3, 1,109 patients of 871,806 eligible patients (<1%) had an LVEF recorded.

CONCLUSIONS : LVEF is a valuable indicator of cardiovascular function for patients with CAD, hypertension, and atrial fibrillation. Registry capture of LVEF was higher than the rate observed in EHRs; fewer than one-half of at-risk cardiac patients in the registry and proportionally far fewer in the EHRs had documented LVEF. Specific guideline-directed medications are indicated for those patients with a decreased LVEF. Documented LVEF is an important patient variable for optimizing guideline-recommended therapy and for informed clinical decision-making for patients with serious cardiovascular disease.