Table 23-1.

ACS Quality-of-Care Measures, 2014

Quality-of-Care MeasureVHA*ACTION-GWTG STEMIACTION-GWTG NSTEMI
Aspirin within 24 h of admission9998.597.9
Aspirin at discharge9999.198.4
β-Blockers at discharge9998.297.2
Lipid-lowering medication at discharge9999.498.9
ARB/ACEI at discharge for patients with LVEF <40%9693.089.8
ACEI at discharge for AMI patientsNM69.456.5
ARB at discharge for AMI patientsNM10.514.9
Adult smoking cessation advice/counselingRetired98.998.4
Cardiac rehabilitation referral for AMI patientsNM84.575.9
  • Values are percentages. ACEI indicates angiotensin-converting enzyme inhibitor; ACS, acute coronary syndrome; ACTION-GWTG, Acute Coronary Treatment and Intervention Outcomes Network Registry–Get With The Guidelines; AMI, acute myocardial infarction; ARB, angiotensin receptor blocker; LVEF, left ventricular ejection fraction; NM, not measured; NSTEMI, non–ST-segment–elevation myocardial infarction; STEMI, ST-segment–elevation myocardial infarction; and VHA, Veterans Health Administration.

  • * VHA: AMI patients. Data reported include data from October 1, 2013, to September 30, 2014.

  • ACTION Registry: STEMI and NSTEMI patients are reported separately. Patients must be admitted with acute ischemic symptoms within the previous 24 hours, typically reflected by a primary diagnosis of STEMI or NSTEMI. Patients who are admitted for any other clinical condition are not eligible. Data reported include data from the first quarter of 2014 to the fourth quarter of 2014.

  • Denotes statin use at discharge. Use of nonstatin lipid-lowering agent was 5.2% for STEMI patients and 8.6% for NSTEMI patients in the ACTION registry.