Acute Myocardial Infarction

National Project Overview

Over 300,000 Medicare patients are hospitalized for heart attack (acute myocardial infarction) each year. Many do not receive important therapies that are known to be beneficial. The National Acute Myocardial Infarction Project focuses on increasing the use of appropriate care processes to improve patient outcomes. The goal is to lower the one-year mortality rate for Medicare beneficiaries following hospital admission for heart attack.

Public Health Importance

Cardiovascular disease is America's biggest killer. Every minute an American dies of coronary heart disease. Each year, approximately 1.1 million people experience an acute myocardial infarction (AMI) or heart attack. Almost two-thirds of heart attack patients do not make a complete recovery, and people who survive the acute phase have a chance of related illness and death that is 2 to 9 times higher than that of the general population. One third dies during the acute phase. Older Americans bear the brunt of this medical burden. Over 80 percent of all heart attack-related deaths occur in individuals age 65 or older.

Heart disease is the leading cause of hospitalization among persons age 65 or older. In 1996, acute myocardial infarction accounted for 394,850 hospitalizations among Medicare beneficiaries, or about 12 hospitalizations for every 1,000 enrollees. The payments to hospitals for these episodes totaled over $3.6 billion, or about $9,780 per discharge.

Main Objective

To decrease the morbidity and mortality associated with AMI in Medicare beneficiaries.

Acute Myocardial Infarction Measures

AMI-1: Aspirin at Arrival
AMI-2: Aspirin Prescribed at Discharge
AMI-3: ACEI or ARB for LVSD
AMI-4: Adult Smoking Cessation Advice/Counseling
AMI-5: Beta Blocker Prescribed at Discharge
AMI-6: Beta Blocker at Arrival
AMI-7: Mean Time to Fibrinolysis
AMI-7a: Fibrinolytic Agent Received within 30 Minutes of Hospital Arrival
AMI-8: Median Time to Primary PCI
AMI-8a: Primary PCI Received Within 90 Minutes of Hospital Arrival
AMI-T1a: LDL Cholesterol Assessment (OPTIONAL TEST MEASURE)
AMI-T2: Lipid Lowering Therapy at Discharge (OPTIONAL TEST MEASURE)

Web Site Links (the following links will open new windows):

Questions?

For more information about this project (including clinical background, performance measures, and references) please visit MedQIC or contact Deanna Curry, Patient Safety Interventionist, at 303.847.1727 or dcurry@coqio.sdps.org.

The Colorado Foundation for Medical Care (CFMC), the Medicare quality improvement organization for Colorado, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS Policy.