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PERFORMANCE MEASURE
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– PERFORMANCE MEASURE SETS –
Ambulatory Care Quality Alliance (AQA)
Cardiovascular Care Performance Measures

AQA Cardiology Starter Set of 8 Measures
in Ambulatory Care [Word .Doc]

Performance Measure
Clinical Topic
Source of
Measure
PVRP
Measure
Description
Coronary Artery Disease
CAD – Level 1 (Core) Measures
1. CAD: Antiplatelet Therapy CMS /
AMA /
ACC/AHA
Percentage of CAD patients who were prescribed antiplatelet therapy.
Numerator – Patients who were prescribed antiplatelet therapy
Denominator – All patients with CAD > 18 years of age
 
a.Antiplatelet therapy may include aspirin, clopidogrel, or combination of aspirin and dipyridamole.
b.Denominator Exclusion – Medical reasons for not prescribing antiplatelet therapy: active bleeding in the previous six months which required hospitalization and/ or transfusion(s), patient on other antiplatelet therapy, etc.
c.Denominator Exclusion – Patient reasons for not prescribing antiplatelet therapy: economic, social, and/or religious, etc.
2. CAD: Beta-Blocker Therapy - Prior Myocardial Infarction (MI) CMS /
AMA /
ACC/AHA
Percentage of CAD patients with prior MI who were prescribed beta-blocker therapy.
Numerator – Patients who were prescribed beta-blocker therapy
Denominator – All patients with CAD > 18 years of age with prior MI.
 
a.Denominator Exclusion – Medical reasons for not prescribing beta-blocker therapy: Document.
b.Denominator Exclusion – Patient reasons for not prescribing beta-blocker therapy: Document.
CAD – Level 2 Measures
3. CAD: Lipid Profile CMS /
AMA /
ACC/AHA
Percentage of CAD patients who received at least one lipid profile (or ALL component tests)
Numerator – Patients who received at least one lipid profile (or ALL component tests)
Denominator – All patients with CAD > 18 years of age.
 
a.Component tests include total cholesterol, HDL-C, LDL-C, and triglycerides.
4. CAD: ACE Inhibitor or Angiotensin Receptor (ARB) Therapy CMS /
AMA /
ACC/AHA
Percentage of CAD patients with diabetes and/or LVSD who were prescribed ACE-I or ARB therapy.
Numerator – Patients who were prescribed ACE-I or ARB therapy
Denominator – All patients with CAD > 18 years of age age who also have diabetes and/or LVSD. Denominator Includes patients with CAD who also have diabetes and/or LVSD (LVEF <40% or with moderately or severely depressed LVSF)
 
a.Denominator Exclusion – Medical reasons for not prescribing ACE-I/ARB: allergy, angioedema due to ACE-I/ARB, anuric renal failure due to ACE-I/ARB, pregnancy, moderate or severe aortic stenosis, etc.
b.Denominator Exclusion – Patient reasons for not prescribing ACE-I/ARB: economic, social, and/ or religious, etc.
Heart Failure
Heart Failure – Level 1 (Core) Measures
5. HF: Left Ventricular Function (LVF) Assessment CMS /
AMA /
ACC/AHA
Percentage of HF patients with quantitative or qualitative results of LVF assessment recorded.
Numerator – Patients with quantitative or qualitative results of LVF assessment recorded
Denominator – All patients with CAD > 18 years of age.
 
This measure requires only documentation of a previous LVF assessment anytime previous in the record and that reassessment should be based on a change in clinical status.
6. HF: Beta-Blocker Therapy CMS /
AMA /
ACC/AHA
Percentage of HF patients with left ventricular systolic dysfunction (LVSD) who were prescribed beta-blocker therapy
Numerator – Patients who were prescribed beta-blocker therapy
Denominator – All patients with HF > 18 years of age with LVEF <40% or with moderately or severely depressed LVSF.
 
a.Denominator Exclusion – Medical reasons for not prescribing beta-blocker therapy: Document.
b.Denominator Exclusion – Patient reasons for not prescribing beta-blocker therapy: economic, social, and/ or religious, etc.
7. HF: ACE Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy CMS /
AMA /
ACC/AHA
Percentage of HF patients with LVSD who were prescribed ACE-I or ARB therapy.
Numerator – Patients who were prescribed ACE-I or ARB therapy
Denominator – All patients with HF > 18 years of age with LVEF <40% or with moderately or severely depressed LVSF.
 
a.Denominator Exclusion – Medical reasons for not prescribing ACE-I or ARB therapy: Document.
b.Denominator Exclusion – Patient reasons for not prescribing ACE-I or ARB therapy: economic, social, and/ or religious, etc.
Heart Failure – Level 2 Measures
8. HF: Warfarin Therapy for Patients with Atrial Fibrillation (AF) CMS /
AMA /
ACC/AHA
Percentage of HF patients with paroxysmal or chronic AF who were prescribed warfarin therapy.
Numerator – Patients who were prescribed warfarin therapy
Denominator – All patients with Heart Failure > 18 years of age with paroxysmal or chronic AF.
 
a.Denominator Exclusion – Medical reasons for not prescribing warfarin therapy: Document.
b.Denominator Exclusion – Patient reasons for not prescribing warfarin therapy: economic, social, and/ or religious, etc.
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