The ACC and the American Heart Association (AHA) have released their first joint document developing a comprehensive set of performance, quality and structural measures related to coronary artery revascularization with the goal of helping health care providers reduce gaps in the quality of care provided to patients.

The 2023 AHA/ACC Clinical Performance and Quality Measures for Coronary Artery Revascularization, which were published in JACC and developed in collaboration with the American Association for Thoracic Surgery and the Society for Cardiovascular Angiography and Interventions, include a total of 22 measures comprising 15 performance measures, 5 quality measures and 2 structural measures.

The writing committee, led by Greg J. Dehmer, MD, MACC, chair, and Cindy L. Grines, MD, FACC, vice chair, "sought to enhance and clarify measures in ways that reflect the advancement of the underlying science, the complexity of care, and the challenges of accurate and complete data collection." Of note, the writing committee decide to retire the 2013 performance measures for adults undergoing PCI and revised the cardiac rehabilitation patient referral measures from the 2018 cardiac rehabilitation measure set and the registry participation measure from the 2013 performance measures for adults undergoing PCI. According to the authors, new and revised measures were aligned wherever possible with those developed by other organizations such as the National Quality Forum, Centers for Medicare and Medicaid Services, and the Society of Thoracic Surgeons.

Going forward, Dehmer, Grines and colleagues write that "coronary artery revascularization is not static but continues to evolve as new techniques, therapies, and treatment strategies emerge." As such, ongoing revision and review of these new measures will need to occur. In particular, they write that "areas presenting opportunities for further research include determining the optimal role and timing for revascularization in cardiogenic shock, research on conduits and techniques for coronary artery bypass graft, the use of mechanical support for high-risk PCI, defining the role of drug-coated balloons, and the optimal duration of antiplatelet therapy after PCI and in the setting of atrial fibrillation." They also highlight the ongoing emergence of new devices for PCI in the market and need for further research in specific patient populations, including women.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Interventions and Imaging, Angiography, Nuclear Imaging, Acute Coronary Syndromes, Cardiac Surgery, Stable Ischemic Heart Disease

Keywords: Medicaid, Medicare, Angiography, Surgeons

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