American Heart Journal
Volume 158, Issue 5 , Pages 748-754.e1 , November 2009

Comparative trends in guidelines adherence among patients with non–ST-segment elevation acute coronary syndromes treated with invasive versus conservative management strategies: Results from the CRUSADE quality improvement initiative

  • Ezra A. Amsterdam, MD

      Affiliations

    • University of California–Davis, Davis, CA
    • ,
  • Eric D. Peterson, MD, MPH

      Affiliations

    • Duke Clinical Research Institute, Durham, NC
    • ,
  • Fang-Shu Ou, MS

      Affiliations

    • Duke Clinical Research Institute, Durham, NC
    • ,
  • L. Kristin Newby, MD, MHS

      Affiliations

    • Duke Clinical Research Institute, Durham, NC
    • ,
  • Charles V. Pollack Jr., MD, MA

      Affiliations

    • Pennsylvania Hospital, Philadelphia, PA
    • ,
  • W. Brian Gibler, MD

      Affiliations

    • University of Cincinnati College of Medicine, Cincinnati, OH
    • ,
  • E. Magnus Ohman, MD

      Affiliations

    • Duke Clinical Research Institute, Durham, NC
    • ,
  • Matthew T. Roe, MD, MHS

      Affiliations

    • Duke Clinical Research Institute, Durham, NC
    • Corresponding Author InformationReprint requests: Matthew Roe, MD, MHS, 2400 Pratt St., Room 7035, Durham, NC 27705.

Received 3 June 2009 ,Accepted 11 September 2009.

References 

  1. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA guidelines for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2000;36:970–1062
  2. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA guideline update for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction—2002: summary article. Circulation. 2002;106:1893–1900
  3. Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction executive summary. J Am Coll Cardiol. 2007;50:e1–e157
  4. LaBresh KA, Ellrodt AG, Glicklick R, et al. Get with the Guidelines for cardiovascular secondary prevention. Arch Intern Med. 2004;164:203–209
  5. GRACE Investigators . Rationale and design of the GRACE (Global Registry of Acute Coronary Events) project: a multinational registry of patients hospitalized with acute coronary syndromes. Am Heart J. 2001;141:190–199
  6. Hoekstra JW, Pollack CV, Roe MT, et al. Improving the care of patients with non–ST-elevation acute coronary syndromes in the emergency department: the CRUSADE initiative. Acad Emerg Med. 2002;9:1146–1155
  7. Krumholz HM, Anderson JL, Bachelder BL, et al. ACC/AHA clinical performance measures for adults with ST-elevation and non–ST-elevation myocardial infarction. J Am Coll Cardiol. 2008;52:2046–2099
  8. Mehta RH, Roe MT, Chen AY, et al. Recent trends in the care of patients with non–ST-segment elevation acute coronary syndromes. Insights from the CRUSADE initiative. Arch Intern Med. 2006;166:2027–2034
  9. Fox KA, Steg PG, Eagle KA, et al. Decline in rates of death and heart failure in acute coronary syndromes, 1999–2006. JAMA. 2007;297:1892–1900
  10. Tricoci P, Peterson ED, Mulgund J, et al. Temporal trends in the use of early cardiac catheterization in patients with non–ST-segment elevation acute coronary syndromes (results from CRUSADE). Am J Cardiol. 2006;98:1172–1176
  11. American Heart Association . Composite, defect-free, and perfect care measures. Available at: www.americanheart.org/presenter.jhtml?identifier=3043627Last accessed April 21, 2009
  12. Roe MT, Chen AY, Delong ER, et al. Patterns of transfer for patients with non–ST-segment elevation acute coronary syndromes from community to tertiary care hospitals. Am Heart J. 2008;156:185–192
  13. Liang KY, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13–22
  14. Peterson ED, Roe MT, Mulgund J, et al. Association between hospital process performance and outcomes among patients with acute coronary syndromes. JAMA. 2006;295:1912–1920
  15. Granger CB, Steg PG, Peterson E, et al. Medication performance measures and mortality following acute coronary syndromes. Am J Med. 2005;118:858–865
  16. Bhatt D, Roe MT, Peterson ED, et al. Utilization of early invasive management strategies for high-risk patients with non–ST-segment elevation acute coronary syndromes. Results from the CRUSADE quality improvement initiative. JAMA. 2004;292:2096–2104
  17. Budaj A, Brieger D, Steg G, et al. Global patterns of use of antithrombotic and antiplatelet therapies in patients with acute coronary syndromes: insights from the Global Registry of Acute Coronary Events. Am Heart J. 2003;146:999–1006
  18. Moscucci M, Fox KAA, Cannon CP, et al. Predictors of major bleeding in acute coronary syndromes: the Global Registry of Acute Coronary Events. Eur Heart J. 2003;24:1815–1823
  19. Franklin K, Goldberg RJ, Spencer F, et al. Implications of diabetes in patients with acute coronary syndromes: the Global Registry of Acute Coronary Events. Arch Intern Med. 2004;164:1457–1463
  20. Alexander KP, Roe MT, Chen AY, et al. Evolution in cardiovascular care for elderly patients with non–ST-segment elevation acute coronary syndromes: results from the CRUSADE national quality improvement initiative. J Am Coll Cardiol. 2005;46:1479–1487
  21. Bach RG, Cannon CP, Weintraub WS, et al. The effect of routine, early invasive management on outcome for elderly patients with non–ST-segment elevation acute coronary syndromes. Ann Intern Med. 2004;141:186–195
  22. Han JH, Chandra A, Mulgund J, et al. Chronic kidney disease in patients with non–ST-segment elevation acute coronary syndromes: results from the CRUSADE Initiative. Am J Med. 2006;119:248–254
  23. Roe MT, Peterson ED, Newby LK, et al. The influence of risk status on guidelines adherence for patients with non–ST-segment elevation acute coronary syndromes. Am Heart J. 2006;151:1205–1213
  24. Chan MY, Becker RC, Harrington RA, et al. Noninvasive, medical management for non–ST-elevation acute coronary syndromes. Am Heart J. 2008;155:397–407
  25. Chan MY, Mahaffey KW, Sun LJ, et al. Prevalence, predictors, and impact of conservative medical management for patients with non–ST-segment elevation acute coronary syndromes who have angiographically documented significant coronary disease. J Am Coll Cardiol Intv. 2008;1:369–378

 Bernard J. Gersh, MB, ChB, DPhil served as guest editor for this article.

PII: S0002-8703(09)00725-X

doi: 10.1016/j.ahj.2009.09.008

American Heart Journal
Volume 158, Issue 5 , Pages 748-754.e1 , November 2009

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