Abstract 4141834: Impact of a quality health care program in Mexico: Preliminary results of "Calidad con Corazon". The AHA GWTG-CAD pilot project in Mexico

• Published in: Circulation (New York, N.Y.) Vol. 150; no. Suppl_1; p. A4141834
• Main Authors: Lugo Gavidia, Leslie Marisol, Saucedo, Jorge, Leiva-Pons, Jose, De Los Rios, Manuel, Gutierrez- Fajardo, Pedro, Arias-Mendoza, Alexandra, Guerra Lopez, Arturo, Cossio-Aranda, Jorge
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 12.11.2024
• Subjects: Acute coronary syndromes; Effectiveness; Disease management
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.150.suppl_1.4141834

Introduction: The healthcare system in Mexico is complex and fragmented which becomes an impediment to implementing national-wide quality improvement initiatives in the cardiovascular area. The American Heart Association Get With The Guidelines® (GWTG) Quality program has become an important tool to improve healthcare standards for patients in US. Aims: To develop for the first time, the "Calidad Con Corazon Program" to apply the AHA GWTG framework in Mexico to improve adherence to guideline-directed medical therapies(GDMT) for the treatment of patients with CAD. Methods/Approach: Calidad con Corazon program included 10 PCI-capable hospitals from five states in Mexico, representing both public and private health systems. Data included patients with ACS/STEMI/NSTEMI diagnosis. All hospitals were provided quality improvement consultations to identify barriers and develop action plans. This analysis includes data from the first 18 months of the project (Sep 2022 to May 2024). Results: We included 2087 patients; Overall, the mean age was 62.1±13.7 and included 73.8% males, with a history of hypertension (57.3%), dyslipidemia (13.6%), diabetes Mellitus (42%), and myocardial infarction (12.3%). Clinical presentation was predominantly STEMI in 66% (n=1378). A progressive improvement overtime was observed on the proportion of patients receiving an ECG in <10 min after arrival to the PCI-hospital, from 53.3% of cases pre-program to 86.2% at 12-18 months after the program (p<0.001). The result was a decrease from a mean of 22.8 minutes to 8.2 minutes respectively (p<0.001). STEMI/NSTEMI patients showed an increase in the proportion of GDMT at discharge for statins(95.2% to 96.9%), betablockers(81.5% to 86%), aspirin(95.4% to 97.1%) and ARB/ACEi(79.5% to 88%). Procedure improvements included a decrease in missing ECG documentation(11.7% to 4.1%), an increase in LVEF measurement (82.7% to 92%), and lipid profile measurement(42.9% to 83.3%). Conclusion: Hospitals participating in the first national quality improvement program in Mexico adopting the AHA's GWTG framework for patients with ACS demonstrated improvement in hospital procedure protocols over a 18 months period, reflected as an improvement in the performance metrics.