Literature DB >> 10952835

Inter-regional differences and outcome in unstable angina; analysis of the international ESSENCE trial. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events.

K A Fox1, S Goodman, F Bigonzi, V Le Louer, M Cohen.   

Abstract

AIMS: Worldwide there is a large variation in outcome (death, myocardial infarction and recurrent myocardial infarction) in patients with unstable angina or non-Q wave myocardial infarction. These variations may be explained by differences in characteristics of the presenting patients. Here we describe differences in patient presentation, treatment protocols and outcome and we investigate their relationship using data from the ESSENCE (Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events) trial.
METHODS: A total of 2981 patients from six countries which enrolled more than 100 patients were included in the present analysis: United States, Canada, Argentina, France, the Netherlands and United Kingdom. Logistic regression analysis was performed to determine the effect of baseline characteristics on regional outcome.
RESULTS: At day 30, the lowest triple end-point rate, irrespective of study drug treatment, was noted in the Netherlands (18.9%) and the highest in Argentina (30.5%). A model including the variables age > or = 65 years, prior angina, diabetes, prior aspirin use, ECG changes at baseline and diagnosis of non-Q wave myocardial infarction and dummy variables for Argentina and France resulted in concordance of about 60%.
CONCLUSIONS: Inter-regional differences in outcome in unstable angina and non-Q wave myocardial infarction patients can reasonably well be explained by differences in patient characteristics. However, other so far unidentified variables present in Argentina and France also contributed to differences in outcome and their effect warrants further investigation. Copyright 2000 The European Society of Cardiology.

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Year:  2000        PMID: 10952835     DOI: 10.1053/euhj.1999.1983

Source DB:  PubMed          Journal:  Eur Heart J        ISSN: 0195-668X            Impact factor:   29.983


  6 in total

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2.  International comparison of mortality rates in patients with non-ST elevation acute coronary events.

Authors:  E P Gurfinkel; G Bozovich; B Mautner
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Authors:  Wei-Ching Chang; William K Midodzi; Cynthia M Westerhout; Eric Boersma; Judith Cooper; Elliot S Barnathan; Maarten L Simoons; Lars Wallentin; E Magnus Ohman; Paul W Armstrong
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4.  Relation between baseline risk and treatment decisions in non-ST elevation acute coronary syndromes: an examination of international practice patterns.

Authors:  P Kaul; L K Newby; Y Fu; D B Mark; S G Goodman; G S Wagner; R A Harrington; C B Granger; F Van de Werf; E M Ohman; P W Armstrong
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5.  Regional variations in hospital management and post-discharge mortality in patients with non-ST-segment elevation acute coronary syndrome.

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  6 in total

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