Quality improvement in acute coronary syndromes: translating evidence into practice

Despite the substantial progress in elucidating the pathophysiology of acute coronary syndromes (ACS) and developing an array of therapeutic advances for the management of these conditions, several challenges still persist. The use of guideline recommendations for the care of patients with ACS by both healthcare providers and hospitals can improve short-term and long-term outcomes and potentially reduce healthcare costs. However, evidence suggests that adherence to guidelines is suboptimal. Several quality improvement programs, by both governmental and nongovernmental organizations, have been developed in an attempt to encourage maximal utilization of evidence-based interventions. In this review, we will examine the evidence for the importance of guideline adherence in the management of ACS, explore predictors of adherence to these guidelines, and provide evidence-based strategies for improving their implementation.