Table 22-3.

Time Trends in GWTG-ACS Quality-of-Care Measures, 2006 to 2012

Quality-of-Care Measure	2006	2007	2008	2009	2010*	2011*	2012*
Aspirin within 24 h of admission	94.7	92.8	91.2	90.9	97	97.6	97.8
Aspirin at discharge	94.4	95.8	94.9	95.5	98	98.3	98.4
β-Blockers at discharge	92.8	94.6	94.5	94.9	96	96.7	97.1
Lipid-lowering medication at discharge	84.5	85.6	81.6	86.8	92†	98.4†	98.8†
Lipid therapy at discharge if LDL cholesterol >100 mg/dL	89.1	90.7	91.9	92.5	NM	NM	NM
ARB/ACEI at discharge for patients with LVEF <40%	87.3	91.1	91.9	91.9	86	87.8	89.7
Adult smoking cessation advice/counseling	94.3	97.4	98.4	98.4	98	98.4	98.4
Cardiac rehabilitation referral for AMI patients	71.1	63.6	52.0	49.1	75	76.5	77.3

Values are percentages.

In the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) registry, the unadjusted in-hospital mortality rate for 2012 was 4.8% (95% confidence interval, 4.6%–4.9%; excludes transfer-out patients). The American Heart Association’s Get With The Guidelines–Coronary Artery Disease (GWTG-CAD) program has merged into the ACTION registry.

AMI indicates acute myocardial infarction; ARB/ACEI, angiotensin receptor blocker/angiotensin-converting enzyme inhibitor; GWTG-ACS, Get With The Guidelines–Acute Coronary Syndrome; LDL, low-density lipoprotein; LVEF, left ventricular ejection fraction; and NM, not measured.

^*Measures from 2006 to 2009 are from the American Heart Association’s GWTG-CAD registry. The 2010 to 2012 measures are from the American Heart Association’s ACTION registry. The 2012 data reported include data from the second quarter of 2012 to the first quarter of 2013.

^†Represents statin use.