TY - JOUR

T1 - 2020 Update of the quality indicators for acute myocardial infarction

T2 - a position paper of the Association for Acute Cardiovascular Care: the study group for quality indicators from the ACVC and the NSTE-ACS guideline group

AU - Schiele, François

AU - Aktaa, Suleman

AU - Rossello, Xavier

AU - Ahrens, Ingo

AU - Claeys, Marc J

AU - Collet, Jean-Philippe

AU - Fox, Keith A A

AU - Gale, Chris P

AU - Huber, Kurt

AU - Iakobishvili, Zaza

AU - Keys, Alan

AU - Lambrinou, Ekaterini

AU - Leonardi, Sergio

AU - Lettino, Maddalena

AU - Masoudi, Frederick A

AU - Price, Susanna

AU - Quinn, Tom

AU - Swahn, Eva

AU - Thiele, Holger

AU - Timmis, Adam

AU - Tubaro, Marco

AU - Vrints, Christiaan J M

AU - Walker, David

AU - Bueno, Hector

AU - Halvorsen, Sigrun

AU - Jernberg, Tomas

AU - Jortveit, Jarle

AU - Blöndal, Mai

AU - Ibanez, Borja

AU - Hassager, Christian

AU - ESC Scientific Document Group

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.

PY - 2021

Y1 - 2021

N2 - AIMS: Quality indicators (QIs) are tools to improve the delivery of evidence-base medicine. In 2017, the European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC) developed a set of QIs for acute myocardial infarction (AMI), which have been evaluated at national and international levels and across different populations. However, an update of these QIs is needed in light of the accumulated experience and the changes in the supporting evidence.METHODS AND RESULTS: The ESC methodology for the QI development was used to update the 2017 ACVC QIs. We identified key domains of AMI care, conducted a literature review, developed a list of candidate QIs, and used a modified Delphi method to select the final set of indicators. The same seven domains of AMI care identified by the 2017 Study Group were retained for this update. For each domain, main and secondary QIs were developed reflecting the essential and complementary aspects of care, respectively. Overall, 26 QIs are proposed in this document, compared to 20 in the 2017 set. New QIs are proposed in this document (e.g. the centre use of high-sensitivity troponin), some were retained or modified (e.g. the in-hospital risk assessment), and others were retired in accordance with the changes in evidence [e.g. the proportion of patients with non-ST segment elevation myocardial infarction (NSTEMI) treated with fondaparinux] and the feasibility assessments (e.g. the proportion of patients with NSTEMI whom risk assessment is performed using the GRACE and CRUSADE risk scores).CONCLUSION: Updated QIs for the management of AMI were developed according to contemporary knowledge and accumulated experience. These QIs may be applied to evaluate and improve the quality of AMI care.

AB - AIMS: Quality indicators (QIs) are tools to improve the delivery of evidence-base medicine. In 2017, the European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC) developed a set of QIs for acute myocardial infarction (AMI), which have been evaluated at national and international levels and across different populations. However, an update of these QIs is needed in light of the accumulated experience and the changes in the supporting evidence.METHODS AND RESULTS: The ESC methodology for the QI development was used to update the 2017 ACVC QIs. We identified key domains of AMI care, conducted a literature review, developed a list of candidate QIs, and used a modified Delphi method to select the final set of indicators. The same seven domains of AMI care identified by the 2017 Study Group were retained for this update. For each domain, main and secondary QIs were developed reflecting the essential and complementary aspects of care, respectively. Overall, 26 QIs are proposed in this document, compared to 20 in the 2017 set. New QIs are proposed in this document (e.g. the centre use of high-sensitivity troponin), some were retained or modified (e.g. the in-hospital risk assessment), and others were retired in accordance with the changes in evidence [e.g. the proportion of patients with non-ST segment elevation myocardial infarction (NSTEMI) treated with fondaparinux] and the feasibility assessments (e.g. the proportion of patients with NSTEMI whom risk assessment is performed using the GRACE and CRUSADE risk scores).CONCLUSION: Updated QIs for the management of AMI were developed according to contemporary knowledge and accumulated experience. These QIs may be applied to evaluate and improve the quality of AMI care.

KW - Humans

KW - Myocardial Infarction/diagnosis

KW - Non-ST Elevated Myocardial Infarction

KW - Quality Indicators, Health Care

KW - Risk Assessment

KW - ST Elevation Myocardial Infarction

U2 - 10.1093/ehjacc/zuaa037

DO - 10.1093/ehjacc/zuaa037

M3 - Journal article

C2 - 33550362

VL - 10

SP - 224

EP - 233

JO - European Heart Journal: Acute Cardiovascular Care

JF - European Heart Journal: Acute Cardiovascular Care

SN - 2048-8726

IS - 2

ER -