European Society of Cardiology quality indicators for the management of acute coronary syndromes: developed in collaboration with the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the ESC

Aims: Closing the evidence-practice gap for the treatment of acute coronary syndrome (ACS) is central to improving quality of care. Under the European Society of Cardiology (ESC) framework, we aimed to develop updated quality indicators (QIs) for the evaluation of quality of care and outcomes for patients with ACS.

Methods and results: A Working Group of experts including members of the ESC Clinical Practice Guidelines Task Force for ACS, Association for Acute Cardiovascular Care, and European Association of Percutaneous Cardiovascular Interventions followed the ESC methodology for QI development. This methodology involved (i) the identification of the domains of ACS care for the diagnosis and management of ACS; (ii) the construction of candidate QIs through a systematic review of the literature; and (iii) the selection of the final set of QIs (using a modified Delphi method). Five domains of care for the diagnosis and management of ACS were identified: (i) structural framework and logistics, (ii) in-hospital non-invasive care, (iii) invasive strategy and periprocedural management, (iv) secondary prevention interventions, and (v) outcomes. In total, 21 main QIs were selected, covering all five domains of care for the diagnosis and management of ACS.

Conclusion: This document defines the five domains of ACS care and provides 21 QIs for the diagnosis and management of ACS. The updated ESC QIs for ACS may be used for quality improvement initiatives.