Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) (NQF 0070)

EMeasure Name Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) EMeasure Id d46da643-5c8a-4c9c-a7d4-9d7ce38a793d
Version number 1 Set Id 9135ef83-2a62-41b2-9fea-b641e1ef09ae
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward American Medical Association - Physician Consortium for Performance Improvement
Endorsed by National Quality Forum
Description Percentage of patients aged 18 years and older with a diagnosis of CAD and prior MI who were prescribed beta-blocker therapy.
Copyright
© 2010 American Medical Association. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
In the absence of contraindications, beta-blocker therapy has been shown to reduce the risk of a recurrent MI and decrease mortality for those patients with a prior MI. 
Clinical Recommendation Statement
Chronic Stable Angina: Class I - Beta-blockers as initial therapy in the absence of contraindications in patients with prior MI. Class I - Beta-blockers as initial therapy in the absence of contraindications in patients without prior MI (ACC/AHA/ACP-ASIM).

Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: Class I - Drugs required in the hospital to control ischemia should be continued after hospital discharge in patients who do not undergo coronary revascularization, patients with unsuccessful revascularization, or patients with recurrent symptoms after revascularization. Upward or downward titration of the doses may be required. Class I - Beta-blockers in the absence of contraindications (ACC/AHA).

Acute Myocardial Infarction: Class I - All but low-risk patients without a clear contraindication to β-adrenoceptor blocker therapy. Treatment should begin within a few days of the event (if not initiated acutely) and continue indefinitely. Class IIa - Low-risk patients without a clear contraindication to β-adrenoceptor blocker therapy. Survivors of non-ST-elevation MI. Class IIb - Patients with moderate or severe LV failure or other relative contraindications to β-adrenoceptor blocker therapy, provided they can be monitored closely (ACC/AHA).

Although no study has determined if long-term β-adrenoceptor blocker therapy should be administered to survivors of MI who subsequently have satisfactorily undergone revascularization, there is no reason to believe that these agents act differently in coronary patients who have undergone revascularization (ACC/AHA).
	
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
Gibbons RJ, Chatterjee K, Daley J, et al. American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients with Chronic Stable Angina). J Am Coll Cardiol. 1999;33:2092-2197.
Reference
Brunwald E, Antman EM, Beasley JW, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients with Unstable Angina). J Am Coll Cardiol. 2000;36:970-1062.
Reference
RJ, Antman EM, Brooks NH, et al. 1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol. 1999;34:890-911.
Definition
Guidance

Table of Contents


Population criteria

Data criteria (QDS Data Elements)

Summary Calculation

Calculation is generic to all measures:



Measure set CLINICAL QUALITY MEASURE SET 2011-2012