Myocardial infarction strikes some 865,000 Americans each year. Treating patients with scientifically proven therapies both in the hospital and at home can markedly increase the chances of survival and a return to an active life.
To aid physicians in achieving this therapeutic goal, the American College of Cardiology ( ACC ) and the American Heart Association ( AHA ) have released Clinical Performance Measures focusing on the most critical steps in the treatment of patients with myocardial infarction.

Practical and to-the-point, the Clinical Performance Measures are distilled from comprehensive ACC/AHA guidelines on the treatment of patients with two forms of myocardial infarction, ST-elevation myocardial infarction ( STEMI ) and non-ST-elevation myocardial infarction ( NSTEMI ), terms that reflect differences in electrocardiographic tracings that define each type of myocardial infarction.

Key criteria outlined in the Clinical Performance Measures include:

- The prescription of Aspirin upon arrival in the emergency room and at discharge from the hospital,

- The prescription of beta blockers upon arrival and discharge,

- The prescription of angiotensin-converting-enzyme ( ACE ) inhibitors or angiotensin-receptor blockers ( ARBs ) upon discharge for patients whose heart has been damaged and no longer pumps as forcefully as it should, and

- Counseling on smoking cessation, as needed.

The ACC/AHA Clinical Performance Measures go a step further, however, calling for:

- Assessment of blood levels of low-density-lipoprotein ( LDL ) cholesterol

- Initiation of cholesterol-lowering therapy as needed,

- Improvements in the measurement of time to treatment for patients who either receive clot-busting medications or undergo catheter-based intervention to open the blocked artery responsible for the myocardial infarction, and

- Documentation of the proportion of patients who receive therapy to open a blocked artery, from among those who are eligible for such therapy.

Source: American College of Cardiology, 2006


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