Lessons learned from the CRUSADE National Quality Improvement Initiative.

The CRUSADE National Quality Improvement Initiative was created to track national care patterns, facilitate process improvement, and improve patient outcomes among patients with acute coronary syndromes (ACS). CRUSADE found that patients in community practice were sicker than those in randomized clinical trials and often failed to receive evidence-based therapies. Dosing regimens of antithrombotic therapy were also suboptimal, raising safety concerns.

Association of evidence-based care processes and outcomes among patients with acute coronary syndromes: performance matters.

The American College of Cardiology and American Heart Association publishes evidence-based guideline recommendations, yet the degree to which these guidelines are followed and the association between hospital guideline adherence and patient outcomes are unknown. Using data from 350 US centers participating in the "Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines" Quality Improvement Initiative, we evaluated the in-hospital treatment and outcomes from 64,775 patients with non-ST-segment elevation acute coronary syndromes. Overall, guideline-recommended treatments were followed in 74% of eligible instances.

In-hospital mortality associated with the use of intra-aortic balloon counterpulsation.

We analyzed in-hospital mortality for patients treated with intra-aortic balloon counterpulsation from the Benchmark Counterpulsation Outcomes Registry (n = 25,136). In-hospital mortality was higher in patients who received only medical interventions (32.5%) than in those who underwent percutaneous (18.