PulseTrendingJournal ClubResearchersJournalsExplore
Instagram
HomeTrendingJournal ClubExplore
Synapse
⌘+K
Synapse
August 8, 2019European Heart Journal - Quality of Care and Clinical Outcomes

Performance of acute coronary syndrome approaches in Brazil: a report from the BRACE (Brazilian Registry in Acute Coronary SyndromEs)

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Diagnostic and therapeutic tools significantly impact ACS morbidity and mortality, but data regarding ACS performance measures are scarce in Brazil.

Does higher adherence to evidence-based therapies (measured by a performance score) reduce in-hospital mortality in patients with acute coronary syndromes?

Population

1150 ACS patients from 72 hospitals in Brazil

Comparison

Performance score across institutions, including teaching vs non-teaching hospitals

Design

Cross-sectional observational epidemiological registry using stratified cluster sampling

Follow-up

In-hospital

Authors

MFMarcelo FrankenRGRobert P. GiuglianoSGShaun G. Goodman

Discussion

Loading...

Member takes

Overview

Supports performance scores for ACS quality monitoring in Brazil; hypothesis-generating for whether adherence interventions reduce mortality.

Key Points

  • To assess adherence to evidence-based performance measures in the management of acute coronary syndromes and determine its impact on in-hospital mortality.
  • Conducted a cross-sectional, observational epidemiological registry (BRACE) using stratified cluster sampling across 72 hospitals (N = 1,150 patients, median age 63 years, 64% male).
  • Developed a performance score ranging from 0 to 100 to evaluate adherence to guideline-recommended diagnostic and therapeutic approaches.
  • Evaluated performance score variation between teaching and non-teaching hospitals and assessed independent predictors of in-hospital mortality using multivariable analysis.
  • The overall mean performance score was 65.9% ± 20.1%, with teaching hospitals demonstrating significantly higher adherence than non-teaching facilities (71.4% ± 16.9% vs 63.4% ± 21%, P < 0.001).
  • Overall in-hospital mortality was 5.2%, with each one-point increase in performance score independently associated with lower mortality (OR = 0.97, 95% CI 0.95–0.98, P < 0.001).
  • Independent clinical predictors of in-hospital death included age per year (OR = 1.06, 95% CI 1.03–1.09, P < 0.001), chronic kidney disease (OR = 3.12, 95% CI 1.08–9.00, P = 0.036), and prior angioplasty (OR = 0.25, 95% CI 0.07–0.84, P = 0.025).

Structured PICO

Does higher adherence to evidence-based therapies (measured by a performance score) reduce in-hospital mortality in patients with acute coronary syndromes?

P
Population
1150 patients with acute coronary syndromes (ACS), median age 63 years, 64% male, from 72 hospitals in Brazil.
I
Intervention
Adoption of evidence-based therapies for ACS, measured by a performance score (PS) varying from 0 to 100.
O
Outcome
In-hospital mortality and performance score comparison between institutionshard clinical

Higher adherence to evidence-based therapies for ACS, as measured by a performance score, is independently associated with lower in-hospital mortality in Brazil.

Cite This Study

Franken et al. (2019) studied this question.

synapsesocial.com/papers/6a0896d0ae7f011b61ddf2c8https://doi.org/10.1093/ehjqcco/qcz045
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Assessment of quality performance measures in patients with acute coronary syndromes: Data from the Portuguese Registry of Acute Coronary Syndromes (ProACS), a nationwide registry2018 · 24 citations
  2. 2Prevalence of modifiable risk factors among patients hospitalized for acute coronary syndrome in Brazil: a call to action for Brazilian healthcare2024
  3. 3Factors associated with compliance to AHA/ACC performance measures in a myocardial infarction system of care in Brazil2017 · 14 citations
  4. 4Portuguese Registry of Acute Coronary Syndromes (ProACS): 15 years of a continuous and prospective registry2018 · 29 citations
  5. 5Enhancing prehospital management of acute coronary syndrome: a continuous improvement approach2026