Xavier Rossello1,2,3, Jesús Medina4, Stuart Pocock2,5, Frans Van de Werf6, Chee Tang Chin7, Nicolas Danchin8, Stephen W-L Lee9, Yong Huo10, Héctor Bueno2,11,12. 1. Department of Cardiology, Hospital Universitari Son Espases (HUSE), Spain. 2. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Spain. 3. Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain. 4. Global Medical Affairs, AstraZeneca, Spain. 5. London School of Hygiene and Tropical Medicine, UK. 6. Department of Cardiovascular Sciences, University of Leuven, Belgium. 7. National Heart Centre Singapore, Singapore. 8. Hôpital Européen Georges Pompidou & René Descartes University, France. 9. Queen Mary Hospital, China. 10. Beijing University First Hospital, China. 11. Instituto de investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre, Spain. 12. Facultad de Medicina, Universidad Complutense de Madrid, Spain.
Abstract
BACKGROUND: The European Society of Cardiology established a set of quality indicators for the management of acute myocardial infarction. Our aim was to evaluate their degree of attainment, prognostic value and potential use for centre benchmarking in a large international cohort. METHODS: Quality indicators were extracted from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) (555 hospitals, 20 countries in Europe and Latin America, 2010-2011) and EPICOR Asia (218 hospitals, eight countries, 2011-2012) registries, including non-ST-segment elevation acute myocardial infarction (n=6558) and ST-segment elevation acute myocardial infarction (n=11,559) hospital survivors. The association between implementation rates for each quality indicator and two-year adjusted mortality was evaluated using adjusted Cox models. Composite quality indicators were categorized for benchmarking assessment at different levels. RESULTS: The degree of attainment of the 17 evaluated quality indicators ranged from 13% to 100%. Attainment of most individual quality indicators was associated with two-year survival. A higher compliance with composite quality indicators was associated with lower mortality at centre-, country- and region-level. Moreover, the higher the risk for two-year mortality, the lower the compliance with composite quality indicators. CONCLUSIONS: When EPICOR and EPICOR Asia were conducted, the European Society of Cardiology quality indicators would have been attained to a limited extent, suggesting wide room for improvement in the management of acute myocardial infarction patients. After adjustment for confounding, most quality indicators were associated with reduced two-year mortality and their prognostic value should receive further attention. The two composite quality indicators can be used as a tool for benchmarking either at centre-, country- or world region-level.
BACKGROUND: The European Society of Cardiology established a set of quality indicators for the management of acute myocardial infarction. Our aim was to evaluate their degree of attainment, prognostic value and potential use for centre benchmarking in a large international cohort. METHODS: Quality indicators were extracted from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) (555 hospitals, 20 countries in Europe and Latin America, 2010-2011) and EPICOR Asia (218 hospitals, eight countries, 2011-2012) registries, including non-ST-segment elevation acute myocardial infarction (n=6558) and ST-segment elevation acute myocardial infarction (n=11,559) hospital survivors. The association between implementation rates for each quality indicator and two-year adjusted mortality was evaluated using adjusted Cox models. Composite quality indicators were categorized for benchmarking assessment at different levels. RESULTS: The degree of attainment of the 17 evaluated quality indicators ranged from 13% to 100%. Attainment of most individual quality indicators was associated with two-year survival. A higher compliance with composite quality indicators was associated with lower mortality at centre-, country- and region-level. Moreover, the higher the risk for two-year mortality, the lower the compliance with composite quality indicators. CONCLUSIONS: When EPICOR and EPICOR Asia were conducted, the European Society of Cardiology quality indicators would have been attained to a limited extent, suggesting wide room for improvement in the management of acute myocardial infarction patients. After adjustment for confounding, most quality indicators were associated with reduced two-year mortality and their prognostic value should receive further attention. The two composite quality indicators can be used as a tool for benchmarking either at centre-, country- or world region-level.
Authors: Suleman Aktaa; Gorav Batra; Lars Wallentin; Colin Baigent; David Erlinge; Stefan James; Peter Ludman; Aldo P Maggioni; Susanna Price; Clive Weston; Barbara Casadei; Chris P Gale Journal: Eur Heart J Qual Care Clin Outcomes Date: 2022-01-05
Authors: Yong Huo; Frans Van de Werf; Yaling Han; Xavier Rossello; Stuart J Pocock; Chee Tang Chin; Stephen W-L Lee; Yi Li; Jie Jiang; Ana Maria Vega; Jesús Medina; Héctor Bueno Journal: Am J Cardiovasc Drugs Date: 2021-02-04 Impact factor: 3.571
Authors: Sergio Leonardi; Claudio Montalto; Gianni Casella; Daniele Grosseto; Alessandra Repetto; Monica Portolan; Federico Fortuni; Filippo Ottani; Marcello Galvani; Laura Sofia Cardelli; Stefano De Servi; Andrea Rubboli; Gaetano Maria De Ferrari; Luigi Oltrona Visconti; Gianluca Campo Journal: Open Heart Date: 2020-12
Authors: José R González-Juanatey; Alejandro Virgós Lamela; José M García-Acuña; Beatriz Pais Iglesias Journal: Rev Esp Cardiol Date: 2020-07-02 Impact factor: 4.753