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Assessing Performance and Quality After Non-ST Segment Elevation Acute Coronary Syndromes

  • Management of Acute Coronary Syndromes (H Jneid, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review summarizes and discusses the evidence base supporting current performance and quality measures used in assessing institutions in their care of patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS).

Recent Findings

Professional societies in the USA and Europe have developed performance and quality measures for NSTE-ACS. These measures are reviewed and updated periodically to reflect the most important evidence from the literature. In the USA, the ACC/AHA Task Force on Performance Measures published the updated 2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non-ST-Elevation Myocardial Infarction. In Europe, the ESC Acute Cardiac Care Association published the 2017 Quality Indicators for acute myocardial infarction. These documents build on guidelines previously developed and published by the two organizations. They include detailed reviews of current and past studies establishing that adherence with guidelines improves clinical outcomes. Both measure sets provide quantitative methodologies to assess program performance. Institutional programs that focus on these validated measures can increase guideline adherence, streamline and standardize care processes, and reduce morbidity and mortality.

Summary

Performance and quality measures have become a critical part of healthcare today, allowing patients, providers, administrators, and payors to assess patient care objectively. They are also becoming an important component of value-based payment programs. To be fair, and useful, for internal institutional assessment, in comparing different institutions, and for value-based payments, only validated performance measures such as these should be employed.

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Abbreviations

ACC:

American College of Cardiology

ACC//AHA-TFPM:

ACC/AHA Task Force on Performance Measures

ACEI:

Ace-inhibitor

ACS:

Acute coronary syndrome

AHA:

American Heart Association

AMI:

Acute myocardial infarction

ARB:

Angiotensin receptor blocker

CABG:

Coronary artery bypass surgery

DAPT:

Dual antiplatelet therapy

ESC:

European Society of Cardiology

GWTG-CAD :

Get with the Guidelines-Coronary Artery Disease Program

LVSD:

Left ventricular systolic dysfunction

NCDR:

National Cardiovascular Data Registries

NSTE-ACS :

Non-ST segment elevation-acute coronary syndrome

NSTEMI:

Non-ST segment elevation myocardial infarction

PCI:

Percutaneous coronary intervention

PM:

Performance measures

QM:

Quality measures

STEMI:

ST segment elevation myocardial infarction

UA:

Unstable angina

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  1. Cardiology Division, University of Texas Health Science Center, McGovern Medical School, Memorial Hermann Heart & Vascular Institute, 6431 Fannin, MSB-1.246, Houston, TX, 77030, USA

    H. Vernon Anderson & Robin Jacob

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Anderson, H.V., Jacob, R. Assessing Performance and Quality After Non-ST Segment Elevation Acute Coronary Syndromes. Curr Cardiol Rep 20, 133 (2018). https://doi.org/10.1007/s11886-018-1081-9

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