The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management

W. Frank Peacock; Phillip D. Levy; Deborah B. Diercks; Shuang Li; Tracy Y. Wang; James McCord; L. Kristin Newby; Anwar Osborne; Michael Ross; David E. Winchester; Michael C. Kontos; Steven Deitelzweig; Deepak L. Bhatt

doi:10.1097/HPC.0000000000000266

The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management

W. Frank Peacock, Phillip D. Levy, Deborah B. Diercks, Shuang Li, Tracy Y. Wang, James McCord, L. Kristin Newby, Anwar Osborne, Michael Ross, David E. Winchester, Michael C. Kontos, Steven Deitelzweig, Deepak L. Bhatt

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Whether American College of Cardiology (ACC) Chest Pain Center (CPC) accreditation alters guidelines adherence rates is unclear. Methods: We analyzed patient-level, hospital-reported, quality metrics for myocardial infarction (MI) patients from 644 hospitals collected in the ACC's Chest Pain-MI Registry from January 1, 2019, to December 31, 2020, stratified by CPC accreditation for >1 year. Results: Of 192,374 MI patients, 67,462 (35.1%) received care at an accredited hospital. In general, differences in guideline adherence rates between accredited and nonaccredited hospitals were numerically small, although frequently significant. Patients at accredited hospitals were more likely to undergo coronary angiography (98.6% vs. 97.9%, P < 0.0001), percutaneous coronary intervention for NSTEMI (55.4% vs. 52.3%, P < 0.0001), have overall revascularization for NSTEMI (63.5% vs. 61.0%, P < 0.0001), and receive P2Y12 inhibitor on arrival (63.5% vs. 60.2%, P < 0.0001). Nonaccredited hospitals more ECG within 10 minutes (62.3% vs. 60.4%, P < 0.0001) and first medical contact to device activation ≤90 minutes (66.8% vs. 64.8%, P < 0.0001). Accredited hospitals had uniformly higher discharge medication guideline adherence, with patients more likely receiving aspirin (97.8% vs. 97.4%, P < 0.0001), angiotensin-converting enzyme inhibitor (46.7% vs. 45.3%, P < 0.0001), beta blocker (96.6% vs. 96.2%, P < 0.0001), P2Y12 inhibitor (90.3% vs. 89.2%, P < 0.0001), and statin (97.8% vs. 97.5%, P < 0.0001). Interaction by accredited status was significant only for length of stay, which was slightly shorter at accredited facilities for specific subgroups. Conclusions: ACC CPC accreditation was associated with small consistent improvement in adherence to guideline-based treatment recommendations of catheter-based care (catheterization and PCI) for NSTEMI and discharge medications, and shorter hospital stays.

Original language	English (US)
Pages (from-to)	173-178
Number of pages	6
Journal	Critical pathways in cardiology
Volume	20
Issue number	4
DOIs	https://doi.org/10.1097/HPC.0000000000000266
State	Published - Dec 1 2021
Externally published	Yes

Keywords

accreditation
guideline compliance
myocardial Infarction

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1097/HPC.0000000000000266

Cite this

Peacock, W. F., Levy, P. D., Diercks, D. B., Li, S., Wang, T. Y., McCord, J., Newby, L. K., Osborne, A., Ross, M., Winchester, D. E., Kontos, M. C., Deitelzweig, S., & Bhatt, D. L. (2021). The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management. Critical pathways in cardiology, 20(4), 173-178. https://doi.org/10.1097/HPC.0000000000000266

Peacock, WF, Levy, PD, Diercks, DB, Li, S, Wang, TY, McCord, J, Newby, LK, Osborne, A, Ross, M, Winchester, DE, Kontos, MC, Deitelzweig, S & Bhatt, DL 2021, 'The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management', Critical pathways in cardiology, vol. 20, no. 4, pp. 173-178. https://doi.org/10.1097/HPC.0000000000000266

@article{1ff277de85dd4f8fbb80c48b6cdb1fe0,

title = "The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management",

abstract = "Background: Whether American College of Cardiology (ACC) Chest Pain Center (CPC) accreditation alters guidelines adherence rates is unclear. Methods: We analyzed patient-level, hospital-reported, quality metrics for myocardial infarction (MI) patients from 644 hospitals collected in the ACC's Chest Pain-MI Registry from January 1, 2019, to December 31, 2020, stratified by CPC accreditation for >1 year. Results: Of 192,374 MI patients, 67,462 (35.1%) received care at an accredited hospital. In general, differences in guideline adherence rates between accredited and nonaccredited hospitals were numerically small, although frequently significant. Patients at accredited hospitals were more likely to undergo coronary angiography (98.6% vs. 97.9%, P < 0.0001), percutaneous coronary intervention for NSTEMI (55.4% vs. 52.3%, P < 0.0001), have overall revascularization for NSTEMI (63.5% vs. 61.0%, P < 0.0001), and receive P2Y12 inhibitor on arrival (63.5% vs. 60.2%, P < 0.0001). Nonaccredited hospitals more ECG within 10 minutes (62.3% vs. 60.4%, P < 0.0001) and first medical contact to device activation ≤90 minutes (66.8% vs. 64.8%, P < 0.0001). Accredited hospitals had uniformly higher discharge medication guideline adherence, with patients more likely receiving aspirin (97.8% vs. 97.4%, P < 0.0001), angiotensin-converting enzyme inhibitor (46.7% vs. 45.3%, P < 0.0001), beta blocker (96.6% vs. 96.2%, P < 0.0001), P2Y12 inhibitor (90.3% vs. 89.2%, P < 0.0001), and statin (97.8% vs. 97.5%, P < 0.0001). Interaction by accredited status was significant only for length of stay, which was slightly shorter at accredited facilities for specific subgroups. Conclusions: ACC CPC accreditation was associated with small consistent improvement in adherence to guideline-based treatment recommendations of catheter-based care (catheterization and PCI) for NSTEMI and discharge medications, and shorter hospital stays.",

keywords = "accreditation, guideline compliance, myocardial Infarction",

author = "Peacock, {W. Frank} and Levy, {Phillip D.} and Diercks, {Deborah B.} and Shuang Li and Wang, {Tracy Y.} and James McCord and Newby, {L. Kristin} and Anwar Osborne and Michael Ross and Winchester, {David E.} and Kontos, {Michael C.} and Steven Deitelzweig and Bhatt, {Deepak L.}",

year = "2021",

month = dec,

day = "1",

doi = "10.1097/HPC.0000000000000266",

language = "English (US)",

volume = "20",

pages = "173--178",

journal = "Critical pathways in cardiology",

issn = "1535-282X",

publisher = "Lippincott Williams and Wilkins",

number = "4",

}

TY - JOUR

T1 - The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management

AU - Peacock, W. Frank

AU - Levy, Phillip D.

AU - Diercks, Deborah B.

AU - Li, Shuang

AU - Wang, Tracy Y.

AU - McCord, James

AU - Newby, L. Kristin

AU - Osborne, Anwar

AU - Ross, Michael

AU - Winchester, David E.

AU - Kontos, Michael C.

AU - Deitelzweig, Steven

AU - Bhatt, Deepak L.

PY - 2021/12/1

Y1 - 2021/12/1

N2 - Background: Whether American College of Cardiology (ACC) Chest Pain Center (CPC) accreditation alters guidelines adherence rates is unclear. Methods: We analyzed patient-level, hospital-reported, quality metrics for myocardial infarction (MI) patients from 644 hospitals collected in the ACC's Chest Pain-MI Registry from January 1, 2019, to December 31, 2020, stratified by CPC accreditation for >1 year. Results: Of 192,374 MI patients, 67,462 (35.1%) received care at an accredited hospital. In general, differences in guideline adherence rates between accredited and nonaccredited hospitals were numerically small, although frequently significant. Patients at accredited hospitals were more likely to undergo coronary angiography (98.6% vs. 97.9%, P < 0.0001), percutaneous coronary intervention for NSTEMI (55.4% vs. 52.3%, P < 0.0001), have overall revascularization for NSTEMI (63.5% vs. 61.0%, P < 0.0001), and receive P2Y12 inhibitor on arrival (63.5% vs. 60.2%, P < 0.0001). Nonaccredited hospitals more ECG within 10 minutes (62.3% vs. 60.4%, P < 0.0001) and first medical contact to device activation ≤90 minutes (66.8% vs. 64.8%, P < 0.0001). Accredited hospitals had uniformly higher discharge medication guideline adherence, with patients more likely receiving aspirin (97.8% vs. 97.4%, P < 0.0001), angiotensin-converting enzyme inhibitor (46.7% vs. 45.3%, P < 0.0001), beta blocker (96.6% vs. 96.2%, P < 0.0001), P2Y12 inhibitor (90.3% vs. 89.2%, P < 0.0001), and statin (97.8% vs. 97.5%, P < 0.0001). Interaction by accredited status was significant only for length of stay, which was slightly shorter at accredited facilities for specific subgroups. Conclusions: ACC CPC accreditation was associated with small consistent improvement in adherence to guideline-based treatment recommendations of catheter-based care (catheterization and PCI) for NSTEMI and discharge medications, and shorter hospital stays.

AB - Background: Whether American College of Cardiology (ACC) Chest Pain Center (CPC) accreditation alters guidelines adherence rates is unclear. Methods: We analyzed patient-level, hospital-reported, quality metrics for myocardial infarction (MI) patients from 644 hospitals collected in the ACC's Chest Pain-MI Registry from January 1, 2019, to December 31, 2020, stratified by CPC accreditation for >1 year. Results: Of 192,374 MI patients, 67,462 (35.1%) received care at an accredited hospital. In general, differences in guideline adherence rates between accredited and nonaccredited hospitals were numerically small, although frequently significant. Patients at accredited hospitals were more likely to undergo coronary angiography (98.6% vs. 97.9%, P < 0.0001), percutaneous coronary intervention for NSTEMI (55.4% vs. 52.3%, P < 0.0001), have overall revascularization for NSTEMI (63.5% vs. 61.0%, P < 0.0001), and receive P2Y12 inhibitor on arrival (63.5% vs. 60.2%, P < 0.0001). Nonaccredited hospitals more ECG within 10 minutes (62.3% vs. 60.4%, P < 0.0001) and first medical contact to device activation ≤90 minutes (66.8% vs. 64.8%, P < 0.0001). Accredited hospitals had uniformly higher discharge medication guideline adherence, with patients more likely receiving aspirin (97.8% vs. 97.4%, P < 0.0001), angiotensin-converting enzyme inhibitor (46.7% vs. 45.3%, P < 0.0001), beta blocker (96.6% vs. 96.2%, P < 0.0001), P2Y12 inhibitor (90.3% vs. 89.2%, P < 0.0001), and statin (97.8% vs. 97.5%, P < 0.0001). Interaction by accredited status was significant only for length of stay, which was slightly shorter at accredited facilities for specific subgroups. Conclusions: ACC CPC accreditation was associated with small consistent improvement in adherence to guideline-based treatment recommendations of catheter-based care (catheterization and PCI) for NSTEMI and discharge medications, and shorter hospital stays.

KW - accreditation

KW - guideline compliance

KW - myocardial Infarction

UR - http://www.scopus.com/inward/record.url?scp=85122110562&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85122110562&partnerID=8YFLogxK

U2 - 10.1097/HPC.0000000000000266

DO - 10.1097/HPC.0000000000000266

M3 - Article

C2 - 34494982

AN - SCOPUS:85122110562

SN - 1535-282X

VL - 20

SP - 173

EP - 178

JO - Critical pathways in cardiology

JF - Critical pathways in cardiology

IS - 4

ER -

The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this