The 2020 ESC-ACVC quality indicators for the management of acute myocardial infarction applied to the FAST-MI registries

Abstract

Aims We estimated the 2020 European Society of Cardiology-Acute Cardio Vascular Care (ESC-ACVC) quality indicators (QI) for the management of acute myocardial infarction, from three existing registries to determine the feasibility of assessment, room for improvement, association with outcomes, and suitability for centre benchmarking. Methods and results Data were extracted from three French nationwide registries, namely FAST-MI 2005, 2010, and 2015. Feasibility of assessment and room for improvement were estimated by the denominator (patients in whom QI could be measured) and numerator (patients who satisfied the QI, among those eligible). Associations between composite QIs (CQIs) and mortality were assessed by multivariate analysis. Centre benchmarking was based on the centres mean CQI, vs. the national mean. The 2020 QIs were measured in 12 660/13 130 patients from FAST-MI. Measurement feasibility ranged from 15% to 100% with greater potential for implementation with the 2020 QI set. The mean (±SD) value of the opportunity-based CQI was 0.72 ± 0.01 and attainment of the all-or-none CQI 8.5%. Both CQIs were associated with adjusted 1-year mortality. Centre categorization into low, intermediate, and high quality was feasible, and distinguished centres with differing mortality. Conclusion Most of the 2020 QI can be measured from existing registries in all domains but not in the patient’s satisfaction domain. This assessment shows potential for implementation. Both CQIs were inversely associated with one-year mortality and centre benchmarking was feasible.

Quality of acute myocardial infarction care in England and Wales during the COVID-19 pandemic: linked nationwide cohort study

“…Quality indicators (QIs) have been increasingly used as a mechanism to measure broad aspects of care, 9 identify unwanted variation 10 11 and drive quality improvement. 12 For AMI, a suite of QIs exist which are valid, 13 internationally recognised 14 and have built on earlier indicators that have an inverse association with mortality. [15][16][17][18][19] We used the UK national cardiovascular registries to investigate the quality of AMI care according to these indicators during the first national lockdown in the COVID-19 pandemic.…”

Quality indicators for acute cardiovascular diseases: a scoping review

“…The number of QI sets may differ because the prevalence of ACS and AHF was higher, and QI sets for ACS and AHF have been reported since the 2000s; therefore, there was a large number of relevant studies. Additionally, the literature listed in our study was used for the assessment of the variation of care and showed the association with better outcome in other studies [ 41 – 43 ]. However, AAD is critical but infrequent, which explains the small number of relevant studies; thus, the validation of QI sets in AAD was limited.…”

Lipid-lowering therapy in patients with coronary artery disease undergoing percutaneous coronary interventions in Italy: an expert opinion paper of Interventional Cardiology Working Group of Italian Society of Cardiology

“…Furthermore, ACS represents a particular setting; early initiation of HIS treatment is associated with improved outcomes, 40,44,45 and is recommended by current practice guidelines. 19 Specifically, ESC guidelines recommend the early use of HIS (daily dose: atorvastatin !…”

“…Furthermore, ACS represents a particular setting; early initiation of HIS treatment is associated with improved outcomes, 40,44,45 and is recommended by current practice guidelines 19 . Specifically, ESC guidelines recommend the early use of HIS (daily dose: atorvastatin ≥ 40 mg or rosuvastatin ≥ 20 mg) in patients with ACS with initiation as soon as possible, irrespective of baseline LDL-C levels (Class I, level of evidence A).…”