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Background  India has a growing burden of cardiovascular disease ( CVD ), yet data on the quality of outpatient care for patients with coronary artery disease, heart failure, and atrial fibrillation in India are very limited. We collected data on performance measures for 68 196 unique patients from 10 Indian cardiology outpatient departments from January 1, 2011, to February 5, 2014, in the American College of Cardiology's  PINNACLE  (Practice Innovation and Clinical Excellence) India Quality Improvement Program ( PIQIP ).  PIQIP  is India's first national outpatient  CVD  quality‐improvement program.    Methods and Results  In the  PIQIP  registry, we estimated the prevalence of  CVD  risk factors (hypertension, diabetes, dyslipidemia, and current tobacco use) and  CVD  among outpatients. We examined adherence with performance measures established by the American College of Cardiology, the American Heart Association, and the American Medical Association Physician Consortium for Performance Improvement for coronary artery disease, heart failure, and atrial fibrillation. There were a total of 68 196 patients (155 953 patient encounters), with a mean age of 50.6 years ( SD  18.2 years). Hypertension was present in 29.7% of patients, followed by diabetes (14.9%), current tobacco use (7.6%), and dyslipidemia (6.5%). Coronary artery disease was present in 14.8%, heart failure was noted in 4.0%, and atrial fibrillation was present in 0.5% of patients. Among eligible patients, the reported use of medications was as follows: aspirin in 48.6%, clopidogrel in 37.1%, and statin‐based lipid‐lowering therapy in 50.6% of patients with coronary artery disease;  RAAS  (renin–angiotensin–aldosterone system) antagonist in 61.9% and beta‐blockers in 58.1% of patients with heart failure; and oral anticoagulants in 37.0% of patients with atrial fibrillation.    Conclusions  This pilot study, initiated to improve outpatient  CVD  care in India, presents our preliminary results and barriers to data collection and demonstrates that such an initiative is feasible in a resource‐limited environment. In addition, we attempted to outline areas for further improvement in outpatient  CVD  care delivery in India.

journal of the american heart association

Cardiovascular Disease Performance Measures in the Outpatient Setting in India: Insights From the American College of Cardiology's PINNACLE India Quality Improvement Program (PIQIP)