Survey of clinical practice pattern in Germany’s certified chest pain units : Adherence to the European Society of Cardiology guidelines on non-ST-segment elevation acute coronary syndrome
| Autor: | Stephan Settelmeier, Tienush Rassaf, Felix Post, Evangelos Giannitsis, Thomas Voigtländer, Frank Breuckmann, Thomas Münzel, Johann Bauersachs, Harald Mudra, Jochen Senges, W. Haerer |
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| Jazyk: | němčina |
| Rok vydání: | 2022 |
| Předmět: |
Response rate (survey)
Acute coronary syndrome medicine.medical_specialty Prasugrel business.industry Medizin Atrial fibrillation medicine.disease Chest pain Internal medicine Conventional PCI medicine Cardiology Myocardial infarction medicine.symptom Cardiology and Cardiovascular Medicine business Ticagrelor medicine.drug |
| Popis: | Background We aimed to analyze the 2020 standard of care in certified German chest pain units (CPU) with a special focus on non-ST-segment elevation acute coronary syndrome (NSTE-ACS) through a voluntary survey obtained from all certified units, using a prespecified questionnaire. Methods The assessment included the collection of information on diagnostic protocols, risk assessment, management and treatment strategies in suspected NSTE-ACS, the timing of invasive therapy in non-ST-segment elevation myocardial infarction (NSTEMI), and the choice of antiplatelet therapy. Results The response rate was 75%. Among all CPUs, 77% are currently using the European Society of Cardiology (ESC) 0/3‑h high-sensitive troponin protocol, and only 20% use the ESC 0/1‑h high-sensitive troponin protocol as a default strategy. Conventional ergometry is still the commonly performed stress test with a utilization rate of 47%. Among NSTEMI patients, coronary angiography is planned within 24 h in 96% of all CPUs, irrespective of the day of the week. Prasugrel is the P2Y12 inhibitor of choice in ST-segment elevation myocardial infarction (STEMI), but despite the impact of the ISAR-REACT 5 trial on selection of antiplatelet therapy, ticagrelor is still favored over prasugrel in NSTE-ACS. If triple therapy is used in NSTE-ACS with atrial fibrillation, it is maintained up to 4 weeks in 51% of these patients. Conclusion This survey provides evidence that Germany’s certified CPUs ensure a high level of guideline adherence and quality of care. The survey also identified areas in need of improvement such as the high utilization rate of stress electrocardiogram (ECG). |
| Databáze: | OpenAIRE |
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