With chronic coronary disease (CCD) the leading cause of death in the U.S., new clinical performance and quality measures released by the ACC and the American Heart Association offer practical steps for managing patient care that are aligned with the latest evidence-based CCD guidelines.

The comprehensive measure set document developed in collaboration with the American College of Clinical Pharmacy, American Society for Preventive Cardiology, Preventive Cardiovascular Nurses Association, and the Society for Cardiovascular Angiography and Interventions, includes 10 performance measures and three quality measures – six of which are new.

Most measures are appropriate for public reporting or pay-for-performance programs, with those that are not ready for reporting purposes potentially useful to clinicians and health care organizations for quality improvement, according to Writing Group Chair Marlene S. Williams, MD, FACC, Vice Chair Glenn N. Levine, MD, FACC, et al.

Highlights from the document include new performance measures for lipid measurement, high-intensity statin use, medical management therapy for blood pressure, and avoidance of routine periodic testing in stable patients. New quality measures address imaging for CCD "to ensure appropriate evaluation in the setting of changing symptoms," as well as ongoing patient education to help inform discussions between patients and clinicians.

Additionally, the writing group revised several measures to reflect new evidence involving blood pressure and lipid control, as well as screening, cessation and intervention for tobacco use. Other revised measures address appropriate antiplatelet therapy; beta-blocker therapy for patients with prior myocardial infarction or left ventricular systolic dysfunction (LVSD); ACE Inhibitor and ARB use in patients with diabetes or LVSD; and cardiac rehabilitation referral for patients with CCD from an outpatient setting.

Looking forward, the document also includes a focus on possible future areas of research ranging from "ideal antiplatelet regimen for secondary prevention and post–acute coronary syndrome" to "clarification on ambulatory blood pressure measurements" in the CCD population.

Read the full document in JACC.