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. 2025 Mar 22;14(3):145-154.
doi: 10.1093/ehjacc/zuaf014.

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

Xavier Rossello  1   2   3 , Maribel Gonzalez-Del-Hoyo  2 , Suleman Aktaa  4   5   6 , Chris P Gale  4   5   6 , Israel Barbash  7   8 , Marc J Claeys  9 , J J Coughlan  10   11 , Joao Pedro Ferreira  12   13 , Mary Galbraith  14 , Margret Leosdottir  15 , Francois Schiele  16 , Sergio Raposeiras-Roubin  17 , Maria Rubini Gimenez  1   18 , Robert A Byrne  10   11 , Borja Ibanez  1   19   20
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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

Xavier Rossello et al. Eur Heart J Acute Cardiovasc Care. .

Abstract

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.

Keywords: Acute coronary syndrome; Quality improvement; Quality indicator; Quality of care.

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Conflict of interest statement

Conflict of interest: X.R., M.G-D-H., S.A., I.B., M.J.C., J.J.C., J.P.F., M.G., S.R-R., and B.I. have nothing to disclose. C.P.G.: Chair of the Data Science Group of European Heart Journal and Deputy Editor of European Heart Journal Quality of Care and Clinical Outcomes. Unrelated to the present work: research grants from Abbott, Bristol Myers Squibb, British Heart Foundation, Horizon 2020, and National Institute for Health and Care Research; speaker’s honoraria from AstraZeneca, Raisio Group, and Wondr Medical; consulting from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Menarini, and Vifor outside the submitted work. M.L. reports institutional grants and honoraria from Amarin, Amgen, AstraZeneca, Bonnier Healthcare, Novo Nordisk, and Sanofi outside the submitted work. M.R.G. reports research grants from the Swiss Heart Foundation and Swiss National Science Foundation (P400PM_180828) and advisor/speakers’ honoraria from Beckman Coulter, Roche, Ortho Clinical Diagnostics, QuidelOrtho, Siemens, and SpinChip (all unrelated to this work). F.S. reports honoraria and consultation fees from Amgen, Sanofi-aventis, NovoNordisk, Servier and Novartis outside the submitted work. R.A.B. reports research grants received by the institutions of employment from Abbott Vascular, Biosensors, Boston Scientific, and Translumina without impact on personal remuneration, and does not accept personal payments from the medical device or pharmaceutical industries.

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