Table 21-3.

Time Trends in GWTG-ACS Quality-of-Care Measures, 2006–2011

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

Values are percentages.

In the ACTION registry (Acute Coronary Treatment and Intervention Outcomes Registry), the unadjusted in-hospital mortality rate for 2011 was 4.6% (95% confidence interval, 4.4%–4.7%); excludes transfer-out patients). The American Heart Association’s (AHA’s) GWTG-CAD has now merged into the ACTION registry.

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

^*Measures from 2006–2009 are from the AHA’s GWTG-CAD (Coronary Artery Disease) registry. 2010/2011 measures are from the AHA’s ACTION registry (Acute Coronary Treatment and Intervention Outcomes Registry.

^†Represents statin use.