Acute Coronary Syndrome
Conditions
Keywords
Myocardial Infarction, Quality Indicator, Percutaneous Coronary Intervention, Unstable Angina
Brief summary
This is a prospective, observational, multicenter study that enroll consecutive and all-comers patients hospitalized with a diagnosis of Acute Coronary Syndrome (ACS) at admission.
Detailed description
This is a Quality Improvement Program which enroll all the consecutive patients hospitalized with ACS. The data elements that are central to the study include the primary and secondary quality indicators (QIs) that are used to define the performance and to promote improved quality of care. At least 3000 patients will be enrolled. The primary endpoint are assessed in-hospital, at admission and discharge. Patients will be followed for 1 year after the ACS.
Interventions
None listed
Sponsors
University Hospital of Ferrara
AUSL Romagna Rimini
Ospedale Morgagni-Pierantoni
IRCCS Multimedica
Azienda Usl di Bologna
Ospedale Santa Maria delle Croci
Azienda USL Reggio Emilia - IRCCS
ASST Cremona
Fondazione IRCCS Policlinico San Matteo di Pavia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* STEACS patients: symptoms of myocardial ischemia and persistent (i.e. \> 20 min) ST elevation in at least two contiguous ECG leads. N.B. Positive biomarkers of cardiac necrosis (i.e. troponin) are not required to confirm the diagnosis. New or presumably new left-bundle branch block at presentation occurs infrequently, may interfere with ST-elevation analysis, and should not be considered diagnostic of acute myocardial infarction (MI) in isolation. * NSTE-ACS patients: symptoms of myocardial ischemia of at least 10 minutes without persistent ST elevation in at least two contiguous ECG leads. To be included in this category patients should have at least one of the following two conditions: a) ECG evidence of NSTEACS defined as T wave inversion in leads with dominant R waves of at least of at least 1 mm (100 μV) or ST segment depression of at least 0.5 mm (50 μV) and/or b) Biomarker evidence of NSTEACS defined as at least one positive (i.e. above the 99th percentile upper reference limit) troponin value (i.e. NSTEMI) * A written informed consent (to agree for a contact, usually by telephone) is required only to patients who are discharged alive.
Exclusion criteria
* Subjects who, in the opinion of the investigator, are unable to comply with study follow up procedures, including, but not limited to, patients who are in prison, who are expected to move to a remote country, or who refuse to be followed should be excluded.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to reperfusion in patients with STEACS and optimal medical therapy at hospital discharge in patients with a final diagnosis of MI or UA. | Baseline |
Secondary
| Measure | Time frame |
|---|---|
| Examine associations of program participation with trends of QIs adherence over 1 year. | 1 year. |
| To monitor the characteristics, treatments, and outcomes of patients hospitalized with ACS. | Baseline |
| To explore the association between evidence-based acute treatment strategies and risk-adjusted clinical outcomes. | 1 year. |
| To measure adherence to a wide range of QIs within multiple domains of care including optimal ACS diagnosis, therapy, and individualized risk assessment through monitoring of process of care measures and benchmarked quality-of-care feedback reports. | Baseline |
| Assess trends in medication dosing patterns, and improve drug safety through targeted quality feedback related to medication overdosing. | Baseline |
| Identify barriers to implementing guideline recommendations for patients with AMI, and develop effective strategies to overcome these barriers | Baseline |
| To assess utilization of diagnostic imaging, laboratory tests and invasive procedures; and track hospital/coronary care unit length-of-stay data. | Baseline |
Countries
Italy
Contacts
Primary ContactSergio Leonardi, MD
Backup ContactMonica Portolan, M.Sc.
Outcome results
None listed