Quality care in ST-segment elevation myocardial infarction

Abstract

Over the past decades, the treatment of ST-segment elevation myocardial infarction (STEMI) has been redefined with the incorporation of evidence from multiple clinical trials. Recommendations from guidelines are updated regularly to reduce morbidity and mortality. However, heterogeneous care systems, physician perspectives, and patient behavior still lead to a disparity between evidence and clinical practice. The quality of care has been established and become an integral part of modern healthcare in order to increase the likelihood of desired health outcomes and adhere to professional knowledge. For patients with STEMI, measuring the quality of care is a multifactorial and multidimensional process that cannot be estimated solely based on patients’ clinical outcomes. The care of STEMI is similar to the concept of “the chain of survival” that emphasizes the importance of seamless integration of five links: early recognition and diagnosis, timely reperfusion, evidence-based medications, control of cholesterol, and cardiac rehabilitation. Serial quality indicators, reflecting the full spectrum of care, have become a widely used tool for assessing performance. Comprehension of every aspect of quality assessment and indicators might be too demanding for a physician. However, it is worthwhile to understand the concepts involved in quality improvement since every physician wants to provide better care for their patients. This article reviews a fundamental approach to quality care in STEMI.

Smartphone based 12 lead ECG as decision support in STEMI: a prospective, cross sectional study, non-randomised, single blinded and single-center study

“…It seems that many STEMI patients frequently delay seeking medical attention for up to two hours following the beginning of symptoms. [5][6][7] Before patients are transported to nearby hospitals for treatment, emergency medical staff on the scene commonly employ ECG to check for deadly electrical arrhythmias and/or ACS. Because to the likely requirement for urgent reperfusion treatment in the presence of ST elevation, an emergent status is often proclaimed and prompt transportation to a hospital equipped to conduct primary PCI is offered.…”

Recent advances in the diagnosis and management of acute myocardial infarction

“…Cardiovascular disease is a leading cause of death worldwide. [1][2][3][4] Acute myocardial infarction (AMI) occurs when a plaque in a coronary artery ruptures or erodes, causing a blood clot that blocks the artery, leading to reduced blood flow to myocardial cells. This is believed to be a dangerous situation that may lead to death.…”

“…Troponin and creatine kinase are current biomarkers for AMI diagnosis, whereas percutaneous coronary intervention (PCI) is the common approach, alongside drug therapies. [2][3][4][8][9][10][11][12][13][14][15][16] The AMI-related in-hospital mortality rate has decreased remarkably, but overall improvement in patient outcomes still requires further effort. 10,17 Novel biomarkers are being explored with the aim of achieving earlier and more accurate diagnosis of AMI.…”