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Acute coronary syndrome care across Australia and New Zealand: the SNAPSHOT ACS study

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Despite well developed guidelines for managing acute coronary syndrome (ACS),1-6 local registries in Australia and New Zealand have demonstrated incomplete implementation of evidence-based recommendations,7-10 with variations in care appearing to correlate with differences in clinical outcomes. Geographical challenges, patient characteristics (including cultural diversity), health workforce and the health policy environment are likely factors affecting the optimal translation of this evidence base into timely, effective and risk-appropriate ACS care.11,12

Audits of hospitalisation for ACS in New Zealand have been crucial in defining treatment and resource gaps in practice.9,13 In Australia, registries have included relatively few patients from regional and remote centres.7 However, health service design and workforce provision have been found to be associated with variations in clinical outcomes in Australia.14 Hence, gaining a binational perspective from multiple health services of current ACS management is an essential step in health services redesign. The SNAPSHOT ACS study sought to inform these efforts by documenting care and outcomes among patients with suspected ACS through a comprehensive audit encompassing all hospitals and jurisdictions…