Assessment of quality performance measures in patients with acute coronary syndromes: Data from the Portuguese Registry of Acute Coronary Syndromes (ProACS), a nationwide registry.

RATIONAL, AIMS, AND OBJECTIVES: Registries are a powerful tool to assess specific performance measurements and quality of care in acute coronary syndromes (ACSs). In Portugal, ProACS is a nationwide registry of ACS that has been active for the past 15 years, and our objective was to assess specific quality indicators for the treatment of ACS.

METHODS: Descriptive analysis of data from ProACS registry in specific quality indicators previously defined by international scientific societies.

RESULTS: A total of 45,141 patients were included since 2002, 43.5% with ST-segment elevation myocardial infarction. In ST-segment elevation myocardial infarction, reperfusion rates, particularly by primary angioplasty, have increased dramatically with 85% being submitted to any form of reperfusion presently. In-hospital time delays are, however, suboptimal, particularly in patients admitted first to hospitals without catheterization facilities. For non-ST elevation ACS, invasive strategy also showed important improvements, with more than 80% of patients being submitted to catheterization. Although there was also improvement in the use of guideline recommended medication, particularly statins, it is also suboptimal, requiring additional specific interventions.

CONCLUSION: The quality of care of ACS improved dramatically in the last 15 years in Portugal, with major improvements in hospital mortality. It is, however, suboptimal in specific points that have been identified and that require additional measures.