Table 23-3.

Time Trends in GWTG-ACS Quality-of-Care Measures, 2006 to 2014

Quality-of-Care Measure20062007200820092010*2011*2012*2013*2014*
Aspirin within 24 h of admission94.792.891.290.99797.697.895.498.1
Aspirin at discharge94.495.894.995.59898.398.498.498.7
β-Blockers at discharge92.894.694.594.99696.797.197.197.6
Lipid-lowering medication at discharge84.585.681.686.89298.498.898.899.1
Lipid therapy at discharge if LDL-C >100 mg/dL89.190.791.992.5NMNMNMNMNM
ARB/ACEI at discharge for patients with LVEF <40%87.391.191.991.98687.889.790.091.2
Adult smoking cessation advice/counseling94.397.498.498.49898.498.498.498.6
Cardiac rehabilitation referral for AMI patients71.163.652.049.17576.577.377.279.4
  • Values are percentages. In the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) registry, the unadjusted in-hospital mortality rate for 2013 was 4.6% (95% confidence interval, 4.5%–4.7%; excludes transfer-out patients). The American Heart Association’s Get With The Guidelines–Coronary Artery Disease (GWTG-CAD) program has merged into the ACTION registry. ACEI indicates angiotensin-converting enzyme inhibitor; AMI, acute myocardial infarction; ARB, angiotensin receptor blocker; GWTG-ACS, Get With The Guidelines–Acute Coronary Syndrome; LDL-C, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; and NM, not measured.

  • * Measures from 2006 to 2009 are from the American Heart Association’s GWTG-CAD registry. The 2010 to 2014 measures are from the American Heart Association’s ACTION registry.

  • Represents statin use. Use of nonstatin lipid-lowering agent was 7.3% for all patients in the ACTION registry-GWTG.