STEMI Registries and the Future of Mission:Lifeline in Virginia

Since 2009, the Virginia Heart Attack Coalition has worked closely with the American Heart Association to improve STEMI care in the Commonwealth. A bedrock principle of this effort has been standardized data collection and regional and state level reporting thru the ACTION Registry (jointly run by the American Heart Association and the American College of Cardiology) and Mission:Lifeline. But as of this Spring, the ACC and AHA no longer co-administer this important registry. The ACC will continue with ACTION, while the AHA has introduced a separate product, Get With the Guidelines-CAD. Many Hospitals are now asking whether to stay with ACTION, or go with the AHA’s GWTG-CAD, and what that means for Virginia.

As partners with the ACC, AHA, and many other organizations, VHAC doesn’t endorse one registry over another. However, the VHAC leadership feels that maintaining a statewide system remains critical to our mission. Given how far we have come with our AHA partners, that system would ideally still be Mission Lifeline. Therefore, our preferred option is to remain on ACTION, but sign up for GWTG-CAD (via the static reports option– details on all GWTG-CAD products available from the AHA). Data from ACTION can then be uploaded data to Mission Lifeline using a CSV file format. This is currently being tested at hospitals in the Mid-Atlantic affiliate and AHA staff will work with you to get your data uploaded.

Conversely, the ACC plans to introduce regional and state reporting for two NCDR registries, ACTION and Cath/PCI. We know that elite STEMI care can only achieved when hospitals and EMS work together in a regional framework and can share data. We ask that hospitals strongly consider what others are doing in their region before making any changes, and ensure that regional STEMI performance data on PCI centers and EMS agencies will continue to be available.

Due to the passion and ceaseless energy of our stakeholders, Virginia has seen dramatic improvements in heart attack care since VHAC/ML was founded. The first medical contact to balloon time has decreased substantially, from the mid 90-minute range to the current median of 77 minutes. The availability of pre-hospital ECGs and EMS education has expanded exponentially. Most areas of the State now have regular regional meetings with presentation of ACTION data and a forum to look for opportunities to improve care even further.

Irrespective of these recent changes, VHAC remains committed to the ideals of our original mission statement: “Working collaboratively to improve systems of care for the early recognition and treatment of all Virginia residents having heart attacks.”


David Burt, MD
University of Virginia
Charlottesville, VA
Michael C. Kontos, MD
Virginia Commonwealth University
Richmond, VA
Peter K. O’Brien, M.D.
Centra Stroobants Cardiovascular Center
Lynchburg, VA



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