Quality of Care for Acute Myocardial Infarction in Argentina. Observations from the SCAR (Acute Coronary Syndromes in Argentina) Registry

pp. 352-358

Abstract

Introduction: Quality assessments help to quantify the gap between healthcare provision and what should be awarded. There are specific measurements on quality of medical care for myocardial infarction which standardize the quality information that every institution should determine for self-assessment and for comparison with others.
Objective: The aim of this study was to analyze quality of care for myocardial infarction data in our country using the SCAR (Acute Coronary Syndromes in Argentina) Multicenter Registry.
Methods: Quality of care data for myocardial infarction was analyzed in patients included in the database of the SCAR Multicenter Registry using definitions of the “ACC/AHA 2008 performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction” document.
Results: The study analyzed 751 myocardial infarction cases with complete data on quality indicators. Aspirin, betablockers, statins and angiotensin antagonists were used in nearly 90% of patients. The exception was clopidogrel which was used in 72.5% of patients not receiving mechanical reperfusion. Ventricular function was assessed during hospitalization in 90.2% of cases. A reperfusion strategy was used in 90.1% of ST-segment-elevation infarctions and less than 12-hour evolution. Door-to-balloon time was < 90 minutes in 50.8% of cases, while door-to-needle time was < 30 minutes in 40.5%.
Conclusions: Overall, there was high compliance to pharmacological and reperfusion treatments except in the use of clopidogrel without mechanical revascularization, and low compliance to the appropriate times of reperfusion therapy.