title: Assessment of quality performance measures for primary percutaneous coronary intervention: A report from a tertiary referral centre in Switzerland.
abstract: OBJECTIVE
  The present study aimed to document a local pattern of care in consecutive patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI) in a tertiary centre in Switzerland.
  
  
  METHODS
  A retrospective study was conducted at the University Hospital of Lausanne, Switzerland. A total of 389 consecutive patients undergoing primary percutaneous coronary intervention for STEMI between 2009 and 2010 were studied. The audit focused on 14 items derived from the American College of Cardiology/American Heart Association 2008 quality performance measures position paper on STEMI management. These indicators all corresponded to a class 1 recommendation at the time of the study period.
  
  
  RESULTS
  All patients received aspirin and anticoagulation within 24 hours after admission. Only 31.3% of patients received beta-blocking agents within 24 hours of admission. Left ventricular function was evaluated in 89.2% of cases and referral for cardiac rehabilitation was achieved in 78.5% of eligible patients. Patients subsequently transferred to another facility for further inpatient care had significantly less evaluation of left ventricular function (82.0% vs. 97.5%, P<0.0001). Global adherence to all performance measures was significantly higher among younger patients (45.9% vs. 31.4%, P<0.0075).
  
  
  CONCLUSIONS
  The present study, which provides a snapshot on quality performance between 2009 and 2010 in a referral centre for primary percutaneous coronary intervention, demonstrates a suboptimal application of the global guidelines on STEMI management. This observation is mainly driven by a low prescription of beta-blocking agents, a class IA indication at that time. This observation should be put in perspective to current practice.
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Céline
authors.initials: C
authors.lastname: Haas
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Stephane
authors.initials: S
authors.lastname: Fournier
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Juan-Fernando
authors.initials: JF
authors.lastname: Iglesias
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Catalina
authors.initials: C
authors.lastname: Trana
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Christan
authors.initials: C
authors.lastname: Roguelov
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Didier
authors.initials: D
authors.lastname: Locca
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lauriers
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Muller
authors.affiliation: Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Switzerland eric.eeckhout@chuv.ch.
authors.forename: Eric
authors.initials: E
authors.lastname: Eeckhout
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000592:standards*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D013557:Switzerland; D062606:Tertiary Care Centers / Q000592:standards*
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors
keywords: ST-elevation myocardial infarction; percutaneous coronary intervention; performance measures; quality of care