NQF Endorses Cardiovascular Measures 

Washington, DC – The National Quality Forum (NQF) Board of Directors has approved for endorsement 39 measures concerning cardiovascular care. The measures – evaluated as part of NQF’s Cardiovascular Endorsement Maintenance 2010 project – address a wide range of cardiovascular issues including hypertension, coronary artery disease, acute myocardial infarction, percutaneous coronary intervention, atrial fibrillation, and heart failure, as well as other treatments, diagnostic studies, interventions, or procedures associated with these conditions.

With heart disease the leading cause of death for men and women in the United States at a cost of $316.4 billion in 2010¹, these measures will help ensure NQF’s cardiovascular portfolio continues to support performance measurement efforts throughout the healthcare field. Notably, this project is the first of its kind to evaluate both new and previously endorsed measures simultaneously.

“This is the first time we have combined our new and endorsement maintenance processes, and it has yielded a very important result in terms of developing a targeted, best-in-class portfolio of cardiac care performance measures,” said Janet Corrigan, PhD, MBA, president and CEO of NQF. “With this new set of measures, NQF is poised to help healthcare stakeholders effectively measure – and improve – critical areas of cardiovascular care.”

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 39 endorsed cardiovascular measures listed below by submitting an appeal no later than Wednesday, February 15. To submit an appeal, please visit the NQF Measure Database. For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

Cardiovascular Endorsement Maintenance 2010 Quality Measures 

CORONARY ARTERY DISEASE - SECONDARY PREVENTION 

• 0076 Optimal vascular care (Minnesota Community Measurement)
• 0073 IVD: blood pressure management (NCQA)
• 0068 IVD: use of aspirin or another antithrombotic (NCQA)
• 0067 CAD: antiplatelet therapy (PCPI)
• 0075 IVD- complete lipid profile and LDL control <100 (NCQA)
• 0074 Chronic stable coronary artery disease: lipid control (PCPI)
• 0066 Chronic stable coronary artery disease: ACE inhibitor or ARB therapy—diabetes or left ventricular systolic dysfunction (LVEF < 40%) (PCPI)
• 0070 Chronic stable coronary artery disease: blocker therapy—prior myocardial infarction (MI) or left ventricular systolic dysfunction (LVEF <40%) (PCPI)
• 0071 AMI: Persistence of beta blocker therapy after a heart attack (NCQA)

CORONARY ARTERY DISEASE - ACUTE PHASE: ACUTE MYOCARDIAL INFARCTION AND PERCUTANEOUS CORONARY INTERVENTION 

• 0289 Median time to ECG (CMS)
• 0286 Aspirin at arrival [for patients being transferred] (CMS)
• 0288 Fibrinolytic therapy received within 30 minutes of ED arrival and Median time to fibrinolysis [for patients being transferred] (CMS)
• 0290 Median time to transfer to another facility for acute coronary intervention (CMS)
• 0132 Aspirin at arrival for acute myocardial infarction (AMI) (CMS)
• 0163 Primary PCI within 90 minutes of hospital arrival (CMS)
• 0164 Fibrinolytic therapy received within 30 minutes of hospital arrival (CMS)
• 0137 ACEI or ARB for left ventricular systolic dysfunction - acute myocardial infarction (AMI) patients (CMS)
• 0355 Bilateral cardiac catheterization rate (IQI 25) (AHRQ)
• 0964 Therapy with aspirin, P2Y12 inhibitor and statin at discharge (ACCF)
• 0133 PCI mortality (risk-adjusted) (ACC)
• 0160 Beta blocker prescribed at discharge (CMS)
• 0142 Aspirin prescribed at discharge for AMI (CMS)
• 0230 Hospital 30-day, all-cause, risk-standardized mortality rate (RSMR) following acute myocardial infarction (AMI) hospitalization for patients 18 and older (CMS)

ATRIAL FIBRILLATION 

• 1524 Assessment of thromboembolic risk – (CHADS 2) (ACCF/AHA/PCPI)
• 1525 Chronic anticoagulation therapy (ACCF/AHA/PCPI)

IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) 

• 1522 ACE/ARB therapy at discharge for ICD implant patients with LVSD (ACCF)
• 1528 Beta blocker at discharge for ICD implant patients with a previous MI (ACCF)
• 1529 Beta blocker at discharge for ICD implant patients with LVSD (ACCF)
• 0965 Patients with an ICD implant who receive prescriptions for all medications (ACE/ARB and beta blockers) for which they are eligible for at discharge (ACCF)

HEART FAILURE 

• 0079 Heart failure: Left ventricular ejection fraction assessment (outpatient setting) (PCPI)
• 0081 Heart failure: ACEI or ARB therapy for left ventricular systolic dysfunction (PCPI)
• 0083 Heart Failure: Beta-blocker therapy for left ventricular systolic dysfunction (PCPI)
• 0135 Evaluation of left ventricular systolic dysfunction (CMS)
• 0162 ACEI or ARB for left ventricular systolic dysfunction – heart failure patients (CMS)
• 0358 Congestive heart failure (CHF) mortality rate (IQI 16)(AHRQ)
• 0229 Hospital 30-day, all-cause, risk-standardized mortality rate (RSMR) following heart failure (HF) hospitalization for patients 18 and older (CMS)
• 0330 Hospital 30-day, all-cause, risk-standardized readmission rate following heart failure hospitalization for patients 18 and older(CMS)
• 0277 CHF admission (PQI 8) (AHRQ)

HYPERTENSION 

• 0018 Controlling high blood pressure (NCQA)

NQF operates under a three-part mission to improve the quality of American healthcare by:  

• building consensus on national priorities and goals for performance improvement and working in partnership to achieve them;  
• endorsing national consensus standards for measuring and publicly reporting on performance; and  
• promoting the attainment of national goals through education and outreach programs. 

1 Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart Disease and Stroke Statistics—2010 Update. A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee . Circulation. 2010;121:e1-e170.