Guideline-adherent therapy in patients with acute coronary syndromes
| Autor: | Uwe Zeymer, S. Genth-Zotz, C.A. Nienaber, P. Schwimmbeck, K. Wolff, H. Heuer |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome Internationality Prasugrel medicine.medical_treatment Cardiology Percutaneous Coronary Intervention Fibrinolytic Agents Germany Internal medicine Antithrombotic medicine Humans Registries cardiovascular diseases Myocardial infarction Acute Coronary Syndrome business.industry Unstable angina Percutaneous coronary intervention Thrombolysis Length of Stay Middle Aged medicine.disease Clopidogrel Practice Guidelines as Topic Female Guideline Adherence Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Herz. 40:27-35 |
| ISSN: | 1615-6692 0340-9937 |
| Popis: | Representative data on the current management of patients with acute coronary syndromes (ACS) are of high interest. The EPICOR registry aimed to prospectively collect such real-life data with particular focus on antithrombotic drug utilization and outcomes. As part of the international prospective EPICOR registry, 29 hospitals in Germany documented 296 patients with ST-elevation myocardial infarction (STEMI)-ACS and 333 with unstable angina or non-STEMI (NSTEMI)-ACS surviving the hospital phase. The statistical analysis was performed in a descriptive manner. The ClinicalTrials.gov identifier is NCT01171404. The mean age of patients was 62 ± 13 years, and 77.4 % were men. Treatment with antithrombotic agents was initiated in the prehospital phase in 50.7 % of STEMI and 33.3 % of NSTEMI patients. During the hospital stay (median 7.0 days), cardiac catheterization was performed in 97.6 %, percutaneous coronary intervention in 85.6 %, thrombolysis in 4.6 %, and coronary bypass surgery in 2.7 % patients. The use of acetylic salicylic acid (ASA) was reported in 95.6 % vs. 96.1 %, clopidogrel in 60.8 % vs. 73.0 %, prasugrel in 45.6 % vs. 22.5 %, any GP IIb/IIIa inhibitor in 52.4 % vs. 18.9 % [any dual combination of ASA+(clopidogrel/prasugrel)in 94.0 vs. 91.0 %], statins in 94.6 % vs. 92.2 %, beta blockers in 96.3 % vs. 94.6 %, and ACE-I/ARB in 91.6 % vs. 87.7 % of STEMI vs. NSTEMI patients, respectively. Combined use of the five drug classes recommended in the guidelines—ASA, P2Y12 antagonists, statin, beta blocker, and ACE-I/ARB—was reported in 81.1 % vs. 69.4 % of STEMI vs. NSTEMI patients, respectively. In Germany a high proportion of patients with ACS are treated according to current guidelines, receiving primary revascularization as well as antithrombotic drugs and other agents for prevention of secondary events; associated bleeding complications were less frequent as compared with published registries. |
| Databáze: | OpenAIRE |
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