Overview of Methodology and Characteristics of National Acute Coronary Syndrome Registries in High Income Countries: A Scoping Review

Background The role of clinical quality registries is to collect structured observational data in routine clinical practice to monitor quality of care provided to specific patient populations. There is currently no standardised methodology of how to establish registry platforms. The objective of this scoping review is to provide an overview of the methodology and characteristics of established national acute coronary syndrome registries. Methods Three electronic databases were searched to identify national registries in high income countries collecting routine clinical data on adult patients with suspected and/or diagnosed acute coronary syndrome. Articles published from the year 2000 onwards that described the protocol and/or quantitative results of such registries located in twenty-five countries with the largest gross domestic product were included. Results There were 24 countries with an established national registry, of which nine are currently active. Inclusion criteria varied across these registries, with a predominant focus on either suspected diagnosis of acute coronary syndrome, or myocardial infarction diagnoses. The primary clinical outcomes measured were all-cause mortality and major adverse cardiovascular events during hospitalisation, as well as at 30-day and/or one year time points. The main sources of follow-up data were hospital discharge records and administrative data linkage. Conclusions Globally, acute coronary syndrome clinical quality registries share similar fundamental objectives of monitoring and improving or sustaining the highest quality of care. However, there is considerable variation in the design of national registries and better harmonisation of fundamental issues such as who is included, core data and key outcomes would be beneficial.