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February 11, 2020Postgraduate Medical Journal

Analysis of situation of acute coronary syndrome based on the date of the Improving Care for Cardiovascular Disease in China–Acute Coronary Syndrome (CCC-ACS) project: single-centre observational study

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Key result

CCC project participation linked to improved GDMT, increased reperfusion, and faster ACS treatment times.

  • n=68,864

Why the study?

China faced an increasing burden of cardiovascular disease and inadequate guideline application in clinical practice, lacking a national performance measurement system and quality improvement strategy.

Does participation in a national quality improvement project improve guideline adherence and clinical outcomes in patients with acute coronary syndrome?

Population

ACS patients from a single centre, Hunan Province (n=4333), and China (n=63 641)

Comparison

Before vs after participating in the CCC project, and single centre vs provincial and national data

Design

Single-centre observational study

Authors

JLJiaying LiFoshan UniversityHPHui PengWannan Medical CollegeXZXiexiong ZhaoCentral South University

Discussion

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Member takes

Overview

Associated with improved ACS process measures via national QI; leaves open outcome benefits and broader applicability.

Study Design

Type

Observational (n=68,864)

Multicenter

Yes

Structured PICO

Does participation in a national quality improvement project improve guideline adherence and clinical outcomes in patients with acute coronary syndrome?

P
Population
Patients with acute coronary syndrome (ACS), including a single-center historical cohort (n=225), a post-intervention single-center cohort (n=665), a provincial cohort (n=4,333), and a national cohort (n=63,641).
I
Intervention
Participation in the Improving Care for Cardiovascular Disease in China (CCC) quality improvement project (evaluation, training, improvement, and re-evaluation).
C
Comparator
Historical control (before participating in the CCC project) and regional/national averages.
O
Outcome
Guideline-directed medical therapy usage rates (aspirin, P2Y12 inhibitor, beta-blocker, statin, ACEI/ARB), hospitalization duration, in-hospital mortality, door-to-needle time, door-to-balloon time, and reperfusion therapy rates.

Implementation of a national quality improvement project significantly improved guideline adherence, reperfusion times, and in-hospital mortality for patients with acute coronary syndrome.

Cite This Study

Li et al. (2020) conducted an observational in Acute coronary syndrome (ACS) (n=68,864). Improving Care for Cardiovascular Disease in China (CCC) project vs. Before participating in the CCC project and regional/national averages was evaluated on Drug usage rates, hospitalisation day, mortality, D-to-N time, D-to-B time, and proportion of reperfusion therapy. Participation in the Improving Care for Cardiovascular Disease in China (CCC) project improved guideline-directed medical therapy, increased reperfusion therapy, and shortened treatment times for ACS.

synapsesocial.com/papers/6a08a8144aa57ff4e0e8a751https://doi.org/10.1136/postgradmedj-2019-137008
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Also Consider

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

  1. 1Hospital Quality Improvement Initiative for Patients With Acute Coronary Syndromes in China2014 · 51 citations
  2. 2Clinical characteristics and in-hospital management strategies in patients with acute coronary syndrome: results from 2,096 accredited Chest Pain Centers in China from 2016 to 20212022 · 11 citations
  3. 3Effect of a Quality of Care Improvement Initiative in Patients With Acute Coronary Syndrome in Resource-Constrained Hospitals in China2019 · 54 citations
  4. 4Doctor-reported hospital management of acute coronary syndrome in China: A nationwide survey of 1029 hospitals in 30 provinces2012 · 10 citations
  5. 5Prospective observational study of acute coronary syndromes in China: practice patterns and outcomes2007 · 94 citations