Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.

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pecially acute coronary syndromes (ACS), are the leading cause of morbidity and mortality globally. 1,2 Large-scale randomized trials have established the efficacy of several interventions for the care of patients with ACS, including antiplatelet therapy, anticoagulation, reperfusion for patients with STsegment elevation myocardial infarction (STEMI), and secondary prevention with aspirin, ␤-blockers, statins, and angiotensin-converting enzyme inhibitors. 3-8 Nevertheless, registries have consistently demonstrated that the translation of research findings into practice is suboptimal 9-11 and that these care gaps are even greater in low-and middle-income countries. 12-15 Changing clinical behavior to improve quality of care is challenging. Prior systematic reviews have suggested that certain quality improvement (QI) tools are associated with better quality of care. 16 These include reminders, educational outreach visits, audit and feedback, case management, and distribution of edu-Author Affiliations and the BRIDGE-ACS Investigators are listed at the end of this article.

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clinicaltrials.gov Identifier: NCT01448642.