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19 Quality indicators Quality indicators are tools that can be used to evaluate care quality, including structures, processes, and outcomes of care.925 They may also serve as a mechanism for enhancing adherence to guideline recommendations, through associated quality improvement initiatives and the benchmarking of care providers.926,927 As such, the role of QIs in improving care and outcomes for CVD is increasingly recognized by healthcare authorities, professional organizations, payers, and the public.925 The ESC understands the need for measuring and reporting quality and outcomes of CV care and has established methods for the development of the ESC QIs for the quantification of care and outcomes for CVDs.925 To date, the ESC has developed QI suites for a number of CVDs in parallel with the writing of the ESC Clinical Practice Guidelines. Previous QIs for the management of AMI have been tested in numerous large registries.928–933 A systematic review of these studies has shown that there is room for improvement in terms of levels of attainment of QIs.934 The ESC aims to harmonize its QIs for various CV conditions and integrate them with ESC registries.935,936 This integrative approach provides ‘real-world’ data about the patterns and outcomes of care for CVD across Europe. 20 Supplementary data Supplementary data are available at European Heart Journal online. 21 Data availability statement No new data were generated or analysed in support of this research. 22 Author information Author/Task Force Member Affiliations: Xavier Rossello, Cardiology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain, Clinical Research Department Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain, Health Research Institute of the Balearic Islands (IdiSBa), Universitat de les Illes Balears (UIB), Palma de Mallorca, Spain; J.J. Coughlan, Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland; Emanuele Barbato, Clinical and Molecular Medicine, Sapienza University, Rome, Italy; Colin Berry, British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom, Cardiology, NHS Golden Jubilee, Clydebank, United Kingdom, Cardiology, NHS Greater Glasgow and Clyde Health Board, Glasgow, United Kingdom; Alaide Chieffo, IRCCS San Raffaele Scientific Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy, University Vita-Salute San Raffaele, Milan, Italy; Marc J. Claeys, Cardiology, Antwerp University Hospital, Edegem, Belgium; Gheorghe-Andrei Dan, Colentina University Hospital, Cardiology Dpt., “Carol Davila” University of Medicine Bucharest, Romania; Marc R. Dweck, British Heart Foundation Centre for Cardiovascular Sciences, Chancellors Building, Little France Crescent, Little France, Edinburgh, United Kingdom; Mary Galbraith (United Kingdom), ESC Patient Forum, Sophia Antipolis, France; Martine Gilard, Cardiology, INSERM UMR 1304 GETBO- Brest University, Brest, France; Lynne Hinterbuchner, Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria; Ewa A. Jankowska, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland, Institute of Heart Diseases, University Hospital in Wroclaw, Wroclaw, Poland; Peter Jüni, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; Takeshi Kimura, Department of Cardiology, Hirakata Kohsai Hospital, Osaka, Japan; Vijay Kunadian, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom, Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Margret Leosdottir, Department of Cardiology, Skane University Hospital, Malmö, Sweden, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden; Roberto Lorusso, Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands; Roberto F.E. Pedretti, Cardiovascular Department, IRCCS MultiMedica, Milan, Italy; Angelos G. Rigopoulos, Adult Cardiology, Mitera General Hospital-Hygeia Group, Athens, Greece; Maria Rubini Gimenez, Department of Internal Medicine and Cardiology, Heart Center Leipzig at the University of Leipzig, Leipzig, Germany, Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland; Holger Thiele, Internal Medicine/Cardiology; Heart Center Leipzig at University of Leipzig, Leipzig, Germany, Leipzig Heart Science, Leipzig, Germany; Pascal Vranckx, Cardiology and Critical Care Medicine, Jessa Ziekenhuis, Hasselt, Belgium, Faculty of Medicine and Life Sciences, University of Hasselt, Hasselt, Belgium; Sven Wassmann, Cardiology, Cardiology Pasing, Munich, Germany; Faculty of Medicine, University of the Saarland, Homburg/Saar, Germany; Nanette Kass Wenger, Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA, United States of America, Consultant, Emory Heart and Vascular Center Emory University, School of Medicine, Atlanta, GA, United States of America, Founding Consultant, Emory Women’s Heart Center, Emory University School of Medicine, Atlanta, GA, United States of America. 23 Appendix ESC Scientific Document Group Includes Document Reviewers and ESC National Cardiac Societies. Document Reviewers: Sigrun Halvorsen (CPG Review Co-ordinator) (Norway), Stefan James (CPG Review Co-ordinator) (Sweden), Magdy Abdelhamid (Egypt), Victor Aboyans (France), Nina Ajmone Marsan (Netherlands), Sotiris Antoniou (United Kingdom), Riccardo Asteggiano (Italy), Maria Bäck (Sweden), Davide Capodanno (Italy), Ruben Casado-Arroyo (Belgium), Salvatore Cassese (Germany), Jelena Čelutkienė (Lithuania), Maja Cikes (Croatia), Jean-Philippe Collet (France), Gregory Ducrocq (France), Volkmar Falk (Germany), Laurent Fauchier (France), Tobias Geisler (Germany), Diana A. Gorog (United Kingdom), Lene Holmvang (Denmark), Tiny Jaarsma (Sweden), Hywel Wynne Jones (United Kingdom), Lars Køber (Denmark), Konstantinos C. Koskinas (Switzerland), Dipak Kotecha (United Kingdom), Konstantin A. Krychtiuk (Austria), Ulf Landmesser (Germany), George Lazaros (Greece), Basil S. Lewis (Israel), Bertil Lindahl (Sweden), Ales Linhart (Czech Republic), Maja-Lisa Løchen (Norway), Mamas A. Mamas ESC Guidelines 3801 Downloaded from academic.oup.com/eurheartj/article/44/38/3720/7243210 by guest on 07 October 2026