New Comprehensive Heart Attack Center certification targets the highest-acuity heart attack care
The American Heart Association and The Joint Commission have introduced a new Comprehensive Heart Attack Center certification for hospitals that provide both cardiac surgical services and primary percutaneous coronary intervention around the clock, all year long. Launched July 1 and announced publicly on August 17, 2022, the certification fills the final slot in a broader cardiac systems-of-care framework designed to match patients with the right hospital at the right time during a medical emergency where minutes can determine myocardial salvage and survival.
Every 40 seconds, someone in the United States has a heart attack. In that setting, variation in hospital capability can translate into variation in outcome.
A certification ladder built around cardiac capability
The new certification completes a continuum that now includes three heart attack care levels and a broader cardiac center designation. Level III, Acute Heart Attack Ready, applies to referring hospitals that may or may not perform primary PCI. Level II, Primary Heart Attack Center, is intended for hospitals that perform primary PCI continuously, every day of the year. Level I, the new Comprehensive Heart Attack Center, adds cardiac surgical services to 24/7 primary PCI. The final designation, Comprehensive Cardiac Center, covers hospitals that deliver care across the full cardiac treatment continuum.
The structure matters because heart attack care is not a single intervention; it is a chain of triage, transport, catheterization, revascularization, surgical backup, and post-procedure monitoring. A patient with ST-segment elevation myocardial infarction may need immediate PCI, but others arrive with anatomy, hemodynamic instability, or procedural complications that require surgical capability on site. Hospitals that can deliver those services together can compress handoffs, reduce delay, and keep complex patients within one coordinated system rather than forcing them through fragmented transfers.
Why system design determines whether evidence reaches the bedside
Cardiac care has long depended on regional systems that decide which hospital receives which patient. Certification formalizes those pathways and pushes them toward evidence-based practice. Edward Jauch, M.D., a volunteer member of the American Heart Association Quality Certification Science Committee and chair of the Department of Research at UNC Health Sciences at Mountain Area Health Education Center, said certified hospitals can help systems function more effectively by providing clear direction on where to take patients. He also pointed to the nation’s aging population and the rising importance of timely treatment in both cardiac and stroke care.
The clinical logic is straightforward. Coronary occlusion deprives myocardium of oxygen; delays widen the infarct zone, weaken ventricular function, and raise the risk of shock, arrhythmia, and death. A hospital system that identifies the right destination early can shorten door-to-balloon time, avoid unnecessary transfers, and preserve more viable heart muscle. The certification is not a treatment itself, but it is an attempt to make treatment reliably available where the burden of illness is highest.
What hospitals must demonstrate to earn the designation
The American Heart Association and The Joint Commission present the certification as recognition for institutions that follow current science-based guidelines in heart attack care. The new CHAC level is reserved for hospitals performing both cardiac surgery and primary PCI around the clock, a combination that matters when patients arrive with complicated coronary disease, failed interventions, or procedural injuries that can turn a routine catheterization lab visit into a surgical emergency.
Mariell Jessup, M.D., FAHA, the American Heart Association’s chief science and medical officer, said the framework is intended to ensure patients receive appropriate, comprehensive heart attack care when they need it most. Her comments reflect a broader policy goal: standardizing not just the cath lab, but the full hospital response to acute coronary syndromes. A facility can have a catheterization suite and still lack the surgical depth needed for the most complex cases. A comprehensive certification recognizes that distinction and places those services under one organized standard.
A practical tool for referral pathways and quality improvement
Once certified, hospitals gain access to an online community, education, resources, quality improvement consultants, a marketing toolkit, and an advisory group. Those benefits may sound administrative, but in cardiac systems they can influence how protocols are written, how transfer agreements are maintained, and how teams review delays after an emergency activation. The downstream effect is more consistent care across institutions that may differ in size, geography, and patient volume.
The certification also arrives with a signal to local EMS, emergency departments, and referring clinicians: not every hospital sits at the same point in the system, and the destination should match the patient’s needs. For the sickest patients, especially those requiring surgical backup, that clarity can reduce dangerous uncertainty during transport decisions. For hospitals, it creates a visible benchmark for performance and readiness rather than a vague claim of cardiac capability.
A broader effort to standardize survival from acute coronary events
The American Heart Association and The Joint Commission have spent years building cardiac certifications that mirror the realities of acute heart attack care. This latest designation rounds out that set and places a formal stamp on hospitals capable of managing the most resource-intensive end of the spectrum. The reference to the policy statement on systems of care for ST-segment elevation myocardial infarction situates the certification within a larger scientific framework that treats regional organization as part of treatment, not as background administration.
The source material does not provide outcome data showing reduced mortality or shorter reperfusion times after certification, so any clinical benefit remains inferential rather than proven in this release. Even so, the intent is unmistakable: to tie hospitals to a common standard, match patients to the right level of care faster, and reduce the delays that turn acute coronary occlusion into irreversible myocardial loss. For health systems, the next question is not whether the framework sounds coherent. It is whether hospitals, EMS networks, and transfer pathways can execute it consistently enough to matter for patients with the most time-sensitive heart attacks.