Clinical Performance Measures focuses on the most critical steps in the treatment of patients with myocardial infarction


Myocardial infarction strikes some 865,000 Americans each year. Treating patients with scientifically proven therapies both in the hospital and at home can markedly increase the chances of survival and a return to an active life.
To aid physicians in achieving this therapeutic goal, the American College of Cardiology ( ACC ) and the American Heart Association ( AHA ) have released Clinical Performance Measures focusing on the most critical steps in the treatment of patients with myocardial infarction.

Practical and to-the-point, the Clinical Performance Measures are distilled from comprehensive ACC/AHA guidelines on the treatment of patients with two forms of myocardial infarction, ST-elevation myocardial infarction ( STEMI ) and non-ST-elevation myocardial infarction ( NSTEMI ), terms that reflect differences in electrocardiographic tracings that define each type of myocardial infarction.

Key criteria outlined in the Clinical Performance Measures include:

- The prescription of Aspirin upon arrival in the emergency room and at discharge from the hospital,

- The prescription of beta blockers upon arrival and discharge,

- The prescription of angiotensin-converting-enzyme ( ACE ) inhibitors or angiotensin-receptor blockers ( ARBs ) upon discharge for patients whose heart has been damaged and no longer pumps as forcefully as it should, and

- Counseling on smoking cessation, as needed.

The ACC/AHA Clinical Performance Measures go a step further, however, calling for:

- Assessment of blood levels of low-density-lipoprotein ( LDL ) cholesterol

- Initiation of cholesterol-lowering therapy as needed,

- Improvements in the measurement of time to treatment for patients who either receive clot-busting medications or undergo catheter-based intervention to open the blocked artery responsible for the myocardial infarction, and

- Documentation of the proportion of patients who receive therapy to open a blocked artery, from among those who are eligible for such therapy.

Source: American College of Cardiology, 2006


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