CCC Project- Acute Coronary Syndrome

Improving Care for Cardiovascular Disease in China: A Collaborative Project of AHA and CSC (CCC Project) - Acute Coronary Syndrome

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02306616

Enrollment

124363

Registered

2014-12-03

Start date

2014-11-30

Completion date

2020-12-31

Last updated

2021-01-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Coronary Syndrome

Brief summary

To develop and implement quality improvement programs for the treatment of acute coronary syndrome (ACS) in China based on the successful experience of the AHA-Get with the Guidelines program. This program will use data collection, analysis, feedback, and process improvement to extend the use of evidence-based guidelines throughout the healthcare system and improve patient care of acute coronary syndrome.

Wenjun Zhu, Tianqi Yang, Linjie Li, Jingbo Yang, Pengfei Sun et al. (100 authors)

European journal of medical research2026-08-27

10.1186/s40001-026-05077-2

In‐Hospital Outcomes of Dual Loading Antiplatelet Therapy in Patients 75 Years and Older With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Findings From the CCC‐ACS (Improving Care for Cardiovascular Disease in China‐Acute Coronary Syndrome) Project

Yongchen Hao, CCC‐ACS Investigators, Hui Ai, Dong Zhao, Yaling Han et al. (17 authors)

UNC Libraries2026-01-31

10.17615/fgfw-7g13

Comparison of in-hospital net clinical outcomes of ticagrelor and clopidogrel in acute coronary syndrome patients stratified by CRUSADE score: findings from the CCC-ACS registry

Yong Huo, Dong Zhao, Yan Zhang, Yongchen Hao, Jing Liu et al. (13 authors)

UNC Libraries2026-01-30

10.17615/0h4y-cw23

Comparison of in-hospital net clinical outcomes of ticagrelor and clopidogrel in acute coronary syndrome patients stratified by CRUSADE score: findings from the CCC-ACS registry.

Zhou Z, Xie H, Fan F, Yang F, Jiang J, Zheng B, Zhang Y, Hao Y, Liu J, Gong Y, Zhao D, Smith SC, Huo Y.

2025-10-27

10.1080/09537104.2025.2570743

Clopidogrel vs. ticagrelor in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary PCI : Findings from a National, multicenter registry.

Zhou C, Zhang M, Zhao Z, Li E, Zhao Y, Luo W, Zheng K, Liu Y, Yin C, Zhang X, Gao H, Zhao D, Ma C.

2025-04-221 citations

10.1186/s12959-025-00721-z

Safety and efficacy of post-procedure anticoagulation in ST-elevation myocardial infarction complicated by cardiogenic shock undergoing primary percutaneous coronary intervention

Can Zhou, Minghui Zhang, Zixu Zhao, Enze Li, Yichen Zhao et al. (15 authors)

BMC Cardiovascular Disorders2025-03-281 citations

10.1186/s12872-025-04639-2

Percutaneous coronary intervention in patients with acute coronary syndromes and increased platelet count

Y. Zhang, Yongchen Hao, Jun Liu, Na Yang, Sidney C. Smith et al. (17 authors)

Archives of cardiovascular diseases2025-02-146 citations

10.1016/j.acvd.2025.01.005

Comparison of Multivessel Versus Culprit‐Vessel‐Only Revascularization in Patients With STEMI and Multivessel Disease During Primary PCI: In‐Hospital Outcomes From the CCC‐ACS Project in China

Tinghao Zhao, Jun Wang, Ruoxi Gu, Dongyuan Sun, Lei Zheng et al. (9 authors)

Catheterization and Cardiovascular Interventions2024-12-10

10.1002/ccd.31332

Incidence and risk factors for cardiac rupture after ST-segment elevation myocardial infarction in contemporary era: findings from the improving care for cardiovascular disease in China-Acute Coronary Syndrome project.

Yang N, Zhao W, Hao Y, Liu J, Liu J, Zhao X, Yan Y, Nie S, Gong W, CCC investigators.

2024-10-27

10.1007/s11739-024-03746-w

In‐Hospital Mortality and Treatment in Patients With Acute Coronary Syndrome With and Without Standard Modifiable Cardiovascular Risk Factors: Findings From the CCC‐ACS Project

Wei Gong, Yan Yan, Jing Liu, Xiao Wang, Wen Zheng et al. (15 authors)

Journal of the American Heart Association2024-09-1811 citations

10.1161/jaha.122.029252

Early β-blocker use and in-hospital outcomes in patients with chronic obstructive pulmonary disease hospitalized with acute coronary syndrome: findings from the CCC-ACS project

Haihua Zhang, Xu Wang, Yucheng Zhang, Tingting Feng, Yujie Zhou et al. (6 authors)

Frontiers in Cardiovascular Medicine2024-07-111 citations

10.3389/fcvm.2024.1385943

Sex Differences in In-Hospital Management and Outcomes of Patients with Acute Coronary Syndrome: Findings from the CCC Project

Yi Hao, Jing Liu, Jing Liu, Na Yang, S.C Smith et al. (15 authors)

UNC Libraries2024-06-073 citations

10.17615/xcv1-b684

LDL cholesterol levels and in-hospital bleeding in patients on high-intensity antithrombotic therapy: findings from the CCC-ACS project

Qing Yang, Dianjianyi Sun, Pei Chen, Yong Zeng, Zehui Wang et al. (24 authors)

2024-05-30

10.17615/htyp-nd98

Trends in Bleeding Events Among Patients With Acute Coronary Syndrome in China, 2015 to 2019: Insights From the CCC-ACS Project

Xiao Wang, Guizhen Zhao, Mi Zhou, Chunyan Ma, Junbo Ge et al. (17 authors)

UNC Libraries2024-05-14

10.17615/q7x3-4030

A Risk Stratification Scheme for In-Hospital Cardiogenic Shock in Patients With Acute Myocardial Infarction

J Q Yang, Pixin Ran, Jianan Li, Qi Zhong, Jr. Smith et al. (19 authors)

UNC Libraries2024-05-10

10.17615/fhwe-n214

Association between early oral β-blocker therapy and risk for in-hospital major bleeding after percutaneous coronary intervention for acute coronary syndrome: findings from CCC-ACS project

Deyue Yan, Z. Li, T. Yang, Luohong Li, Xiaoqin Song et al. (15 authors)

2024-05-10

10.17615/mghs-sy31

Renin-angiotensin system inhibition and in-hospital mortality in acute coronary syndrome patients with advanced renal dysfunction: findings from CCC-ACS project and a nationwide electronic health record-based cohort in China.

Li Z, Sun H, Hao Y, Liu H, Jin Z, Li L, Zhang C, Ma M, Teng T, Chen X, Shen Y, Yu Y, Liu J, Richards AM, Tan HC, Zhao D, Zhou X, Yang Q.

2023-12-015 citations

10.1093/ehjqcco/qcad006

Characteristics, Treatment, and In-Hospital Outcomes of Older Patients With STEMI Without Standard Modifiable Risk Factors.

Zhao G, Zhou M, Zhao X, Ma C, Han Y, Liu J, Zhao D, Nie S, CCC-ACS Investigators.

2023-11-217 citations

10.1016/j.jacasi.2023.09.013

A Small Increase in Serum Creatinine within 48 h of Hospital Admission Is an Independent Predictor of In-Hospital Adverse Outcomes in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Findings from the Improving Care for Cardiovascular Disease in the China Project

Jiajia Zhu, Wenxian Liu, Li Jiang, Changsheng Ma, Dong Zhao

Cardiology Research and Practice2023-03-285 citations

10.1155/2023/1374206

Association between P2Y12 inhibitor reloading and in-hospital outcomes for patients with non-ST-segment elevation acute coronary syndrome already on chronic P2Y12 receptor inhibitors therapy in China: findings from the CCC–ACS (improving care for cardiovascular disease in China-acute coronary syndrome) project

Yintang Wang, Yu Geng, Ou Zhang, Qin Xu, Yajun Xue et al. (100 authors)

European journal of medical research2023-02-02

10.1186/s40001-023-01025-6

Practice of reperfusion in patients with ST-segment elevation myocardial infarction in China: findings from the Improving Care for Cardiovascular Disease in China–Acute Coronary Syndrome project

Yiqian Yang, Yongchen Hao, Jun Liu, Na Yang, Danqing Hu et al. (9 authors)

Chinese Medical Journal2022-12-054 citations

10.1097/cm9.0000000000002257

Risk Factors for In-Hospital Cardiac Arrest in Patients With ST-Segment Elevation Myocardial Infarction.

Gong W, Yan Y, Wang X, Zheng W, Smith SC, Fonarow GC, Morgan L, Liu J, Zhao D, Ma C, Han Y, Montalescot G, Nie S, CCC-ACS Investigators.

2022-11-0116 citations

10.1016/j.jacc.2022.08.797

In-hospital outcomes of ticagrelor versus clopidogrel in patients 75 years or older with acute coronary syndrome: findings from the Improving Care for Cardiovascular Disease in China (CCC)–Acute Coronary Syndrome Project

Na Yang, Jing Liu, Jun Liu, Yongchen Hao, Jr Sidney C Smith et al. (100 authors)

Age and Ageing2022-11-013 citations

10.1093/ageing/afac231

Association between Early Oral β-Blocker Therapy and Risk for In-Hospital Major Bleeding after Percutaneous Coronary Intervention for Acute Coronary Syndrome: Findings from CCC-ACS Project

Shaopeng Xu, Ziping Li, Tianqi Yang, Linjie Li, Xiwen Song et al. (15 authors)

European Heart Journal - Quality of Care and Clinical Outcomes2022-06-175 citations

10.1093/ehjqcco/qcac036

Estimated glomerular filtration rate derived from different formulas and prognosis in acute coronary syndrome: Findings from the improving care for cardiovascular disease in China-acute coronary syndrome project.

Lin YW, Huang JL, Wei XB, Jiang M, Ran P, Li J, Qiu J, Zhong Q, Zhou YL, Chen JY, Yu DQ.

2022-06-023 citations

10.1016/j.amjms.2021.10.034

In-hospital outcomes of Ticagrelor versus Clopidogrel in high bleeding risk patients with acute coronary syndrome: Findings from the CCC-ACS project.

Wang Y, Yang N, Suo M, Liu X, Wang Z, Zhang X, Liu J, Zhao D, Wu X, CCC-ACS Investigators.

2022-05-104 citations

10.1016/j.thromres.2022.04.004

A Risk Stratification Scheme for In-Hospital Cardiogenic Shock in Patients With Acute Myocardial Infarction

Junqing Yang, Peng Ran, Jie Li, Qi Zhong, Sidney C. Smith et al. (18 authors)

Frontiers in Cardiovascular Medicine2022-03-044 citations

10.3389/fcvm.2022.793497

Proton Pump Inhibitors and In-Hospital Gastrointestinal Bleeding in Patients With Acute Coronary Syndrome Receiving Dual Antiplatelet Therapy.

Zhou M, Zhang J, Liu J, Smith SC, Ma C, Ge J, Huo Y, Fonarow GC, Liu J, Hao Y, Gao F, Sun Y, Morgan L, Yang N, Hu G, Zeng Y, Han Y, Zhao D, CCC-ACS Investigators.

2022-02-128 citations

10.1016/j.mayocp.2021.11.037

Trends in Bleeding Events Among Patients With Acute Coronary Syndrome in China, 2015 to 2019: Insights From the CCC-ACS Project

Xiao Wang, Guanqi Zhao, Mengge Zhou, Changsheng Ma, Junbo Ge et al. (17 authors)

Frontiers in Cardiovascular Medicine2021-12-136 citations

10.3389/fcvm.2021.769165

The association between atrial fibrillation and in-hospital outcomes in chronic kidney disease patients with acute coronary syndrome: findings from the improving care for cardiovascular disease in China-acute coronary syndrome (CCC-ACS) project

Lijiao Yang, Nan Ye, Guoqin Wang, Weijing Bian, Fengbo Xu et al. (12 authors)

BMC Cardiovascular Disorders2021-07-172 citations

10.1186/s12872-021-02125-z

LDL cholesterol levels and in-hospital bleeding in patients on high-intensity antithrombotic therapy: findings from the CCC-ACS project

Qing Yang, Dongdong Sun, Chongzhe Pei, Yuhong Zeng, Zhuoqun Wang et al. (25 authors)

European Heart Journal2021-06-1843 citations

10.1093/eurheartj/ehab418

A risk score to predict in-hospital mortality in patients with acute coronary syndrome at early medical contact: results from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) Project

Peng Ran, Junqing Yang, Jie Li, Guang Li, Yan Wang et al. (16 authors)

Annals of Translational Medicine2021-01-0116 citations

10.21037/atm-21-31

Clinical significance of glycated hemoglobin in acute coronary syndrome patients from the CCC-ACS project : Findings from a multicenter retrospective observational study.

Zhao X, Kang Y, Wang X, Yang X, Ai G, Liu Y, Xu P, Zhang J, Gu C, Zhang Y, Hao Y, Zhao D, Han Y, CCC investigators.

2020-11-241 citations

10.1007/s00059-020-04999-9

Smoking and Provision of Smoking Cessation Interventions among Inpatients with Acute Coronary Syndrome in China: Findings from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project

Guoliang Hu, Mengge Zhou, Jing Liu, Sidney C. Smith, Changsheng Ma et al. (17 authors)

Global Heart2020-10-2320 citations

10.5334/gh.784

Admission fasting plasma glucose is associated with in-hospital outcomes in patients with acute coronary syndrome and diabetes: findings from the improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome (CCC-ACS) project.

Ye N, Yang L, Wang G, Bian W, Xu F, Ma C, Zhao D, Liu J, Hao Y, Liu J, Yang N, Cheng H, CCC-ACS.

2020-08-2010 citations

10.1186/s12872-020-01662-3

Prevalence and in-hospital outcomes of diabetes among patients with acute coronary syndrome in China: findings from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project

Mengge Zhou, Jing Liu, Yongchen Hao, Jun Liu, Yong Huo et al. (15 authors)

UNC Libraries2019-08-187 citations

10.17615/k0t7-kw29

Sex Differences in In-Hospital Management and Outcomes of Patients With Acute Coronary Syndrome

Yongchen Hao, Jing Liu, Jun Liu, Na Yang, Sidney C. Smith et al. (16 authors)

Circulation2019-01-22224 citations

10.1161/circulationaha.118.037655

Zhou M, Liu J, Hao Y, Liu J, Huo Y, Smith SC, Ge J, Ma C, Han Y, Fonarow GC, Taubert KA, Morgan L, Yang N, Xing Y, Zhao D, CCC-ACS Investigators.

2018-11-2764 citations

10.1186/s12933-018-0793-x

Guanqi Zhao, Mengge Zhou, Changsheng Ma, Yong Huo, Sidney C. Smith et al. (17 authors)

Journal of the American Heart Association2018-03-3018 citations

10.1161/jaha.117.008100

Invasive Management Strategies and Antithrombotic Treatments in Patients With Non–ST-Segment–Elevation Acute Coronary Syndrome in China

Qing Yang, Ying Wang, Jing Liu, Jun Liu, Yongchen Hao et al. (16 authors)

Circulation Cardiovascular Interventions2017-06-0129 citations

10.1161/circinterventions.116.004750

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Healthy volunteers

Inclusion criteria

Hospitalized patients with discharge diagnosis as acute coronary syndrome (including STEMI, NSTEMI and UAP) in 150 tertiary and 100 secondary hospitals.

Exclusion criteria

None

Design outcomes

Primary

Measure	Time frame	Description
The overall composite of 11 performance measures for ACS care	Duration of hospital stay, an expected average of 1 week	Performance measures for ACS care including: 1. Proportion of patients received aspirin at arrival 2. Proportion of patients received fibrinolytic therapy within 30 mins (STEMI) 3. Proportion of patients received primary percutaneous coronary intervention within 90 mins (STEMI) 4. Proportion of patients received reperfusion therapy (STEMI) 5. Proportion of patients with aspirin prescribed at discharge 6. Proportion of patients with clopidogrel or other P2Y12 inhibitors prescribed at discharge 7. Proportion of patients with beta-blocker prescribed at discharge 8. Proportion of patients with statin prescribed at discharge 9. Proportion of patients received evaluation of left ventricular systolic function 10. Proportion of left ventricular systolic dysfunction patients with ACEI or ARB prescribed at discharge 11. Proportion of patients received smoking cessation advice/ counseling

Countries

China

Outcome results