Quality of Care for Acute Coronary Syndrome Patients With Known Atherosclerotic Disease
Key result
Among 143,999 acute coronary syndrome patients, those with prior atherosclerosis had higher in-hospital mortality and were less likely to receive evidence-based treatments than those without.
Why the study?
Does the presence of prior vascular disease affect compliance with evidence-based quality-of-care treatments and in-hospital mortality in patients presenting with acute coronary syndrome?
Population
143,999 patients with acute coronary syndrome enrolled at 438 sites between January 2000 and January 2008…
Comparison
Presence of known preexistent atherosclerosis in… vs Absence of known preexistent atherosclerosis
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Member takes
Implication
Signals quality-of-care gap in ACS with prior atherosclerosis; hypothesis-generating and requires prospective confirmation before guiding practice.
Study Design
Type
Observational (n=143,999)
Multicenter
Yes
Structured PICO
Does the presence of prior vascular disease affect compliance with evidence-based quality-of-care treatments and in-hospital mortality in patients presenting with acute coronary syndrome?
P
Population
143,999 patients with acute coronary syndrome enrolled at 438 sites between January 2000 and January 2008, classified by the absence (n=98,136) or presence of known preexistent atherosclerosis in 1, 2, or 3 vascular territories (n=37,633, n=7,369, and n=861, respectively).
I
Intervention
Presence of known preexistent atherosclerosis (before admission) in 1, 2, or 3 vascular territories (coronary, cerebrovascular, or peripheral arterial)
C
Comparator
Absence of known preexistent atherosclerosis
O
Outcome
Compliance with quality-of-care treatments (lipid-lowering therapy, smoking cessation counseling, and angiotensin-converting enzyme inhibitor for left ventricular dysfunction) and in-hospital mortality
Patients with acute coronary syndrome and prior atherosclerosis have higher in-hospital mortality but paradoxically receive fewer evidence-based secondary prevention treatments, highlighting a critical gap in quality of care.
Cite This Study
Brilakis et al. (2009) conducted an observational in Acute Coronary Syndrome (n=143,999). Prior atherosclerosis in 1 or more vascular territories vs. Absence of prior vascular disease was evaluated on Compliance with quality-of-care treatments and in-hospital mortality. Among 143,999 acute coronary syndrome patients, those with prior atherosclerosis had higher in-hospital mortality and were less likely to receive evidence-based treatments than those without.