One way to evaluate the care of patients diagnosed with heart attack (acute myocardial infarction or AMI) is to look at the percentage of patients receiving all of the measures appropriate for them. The goal is 100 percent.
The graph displays the percentage of eligible Mayo Clinic patients diagnosed with heart attack who received all of the appropriate care measures in the list below.
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The quality measures listed in the table below are known as the "standards of care" for heart attack. This list includes the medical care widely accepted as the most appropriate form of treatment for the majority of patients diagnosed with heart attack (AMI).
|Standards of care for AMI||Explanation of this care|
|Percent of heart attack patients given angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for left ventricular systolic dysfunction (LVSD)||ACE inhibitors and ARBs are medicines used to treat heart failure or decreased function of the heart.|
|Percent of heart attack patients given aspirin at arrival||Aspirin can help keep blood clots from forming or enlarging during a heart attack.|
|Percent of heart attack patients given aspirin at discharge||Taking aspirin may help prevent further heart attacks.|
|Percent of heart attack patients given beta blocker at discharge||Beta blockers are a type of medicine used to lower blood pressure, treat chest pain (angina) and heart failure, help limit the size of a heart attack, and reduce the chance of death after a heart attack.|
|Percent of heart attack patients given fibrinolytic medication within 30 minutes of arrival for ST-elevation myocardial infarction||Blood clots cause this type of heart attack. Doctors may give this medicine to dissolve blood clots or may perform a procedure to open the blockage, and in some cases, may do both.|
|Percent of heart attack patients given percutaneous coronary intervention (PCI) within 90 minutes of arrival for ST-elevation myocardial infarction||PCI is often the most effective method for opening blocked blood vessels that cause heart attacks. Doctors may perform PCI or give medicine to open the blockage, and in some cases, may do both.|
|Percent of heart attack patients prescribed a statin at discharge||Statin medications are used to lower cholesterol. The major effect of statin medications is to lower LDL cholesterol levels. The use of a statin medication may reduce the risk of death and recurrent cardiovascular events in patients with established cardiovascular disease.|
|Percent of patients who received all of the measures for which they were eligible, otherwise known as all eligible||The all-eligible measure reflects the percentage of patients who received the best care possible.|
|Appropriate care measure (ACM)||The ACM is a pass-fail measure at the individual patient level that asks whether an eligible patient has received all of the appropriate care for the condition for which he or she is being treated.|
Studies have shown the most crucial element affecting the survival of patients having a heart attack is how quickly the arteries of the heart are reopened. While all elements of AMI care are important, the faster a patient receives thrombolytic medication or percutaneous coronary intervention (PCI), the more likely he or she is to survive.
As part of the major improvement initiative to improve AMI care, Mayo Clinic sites streamlined processes to shorten the time required to open the affected artery during a heart attack. Particular attention was paid to minimizing the steps involved in diagnosing the heart attack and getting the patient to the cardiac catheterization laboratory for the PCI procedure.
The data shows an overall increase across all sites in the percentage of cases in which patients received the PCI within 90 minutes of arrival at the hospital.