Table 21-10.

Timely Reperfusion for ACS and Stroke, 2011

Quality-of-Care Measure	VHA* (for STEMI) or GWTG-Stroke (for Stroke)	National Data From HIQR Program†	ACTION-GWTG STEMI‡
STEMI
tPA within 30 min	50§	58.1	46.8§
PCI within 90 min	69	92.5	94.2
Stroke
IV tPA in patients who arrived <2 h after symptom onset, treated ≤3 h	78.3	N/A	N/A
IV tPA in patients who arrived <3.5 h after symptom onset, treated ≤4.5 h	57.9	N/A	N/A
IV tPA door-to-needle time ≤60 min	33.8	N/A	N/A

Values are percentages.

ACS indicates acute coronary syndrome; VHA, Veterans Health Administration; STEMI, ST-segment–elevation myocardial infarction; GWTG-Stroke, Get With The Guidelines–Stroke; HIQR, Hospital Inpatient Quality Reporting; ACTION-GWTG, Acute Coronary Treatment and Intervention Outcomes Registry–Get With The Guidelines; tPA, tissue-type plasminogen activator; PCI, percutaneous coronary intervention; IV, intravenous; and N/A, not applicable.

^*VHA: acute myocardial infarction patients.

^†HIQR Program includes data from all payers, including Medicare and Medicaid.

^‡ACTION Registry: STEMI and NSTEMI patients are reported separately. Patients must be admitted with acute ischemic symptoms within the previous 24 hours, typically reflected by a primary diagnosis of STEMI or NSTEMI. Patients who are admitted for any other clinical condition are not eligible.

^§Indicates low number.