INTRODUCTION AND OBJECTIVES: To investigate the clinical characteristics and treatment of acute coronary syndromes (ACS), and to determine the effects of an early invasive strategy (EIS) in non-ST-elevation ACS (NSTEACS) and of primary percutaneous coronary intervention (PCI) in ST-elevation ACS (STEACS). METHODS: Data were collected prospectively for 9 months during 2004-2005 from 50 hospitals, which were randomly selected according to the level of care provided. In addition, follow-up data on mortality and readmission for ACS were collected for 6 months. The adjusted effects of different reperfusion strategies were analyzed. RESULTS: After checking data quality, the analysis included data from 32 hospitals, which covered 7923 coronary events (4431 [56%] STEACS, 3034 [38%] NSTEACS and 458 [6%] unclassified ACS) in 7251 patients. Compared with previous studies, the use of primary PCI in STEACS had increased markedly (from 10.7% to 36.8% of patients undergoing reperfusion), as had the use of EIS in NSTEACS (from 11.1% to 19.6%). Overall in-hospital mortality was 5.7% (95% confidence interval [CI], 5.1%-6.2%); for STEACS it was 7.6% (95% CI, 6.7%-8.7%), for NSTEACS 3.9% (95% CI, 3.3%-4.6%), and for unclassified ACS 8.8% (95% CI, 6.2%-12.2%). In the population as a whole, there was no association between prognosis (i.e., 6-month mortality) and EIS in NSTEACS (hazard ratio [HR]=0.94; 95% CI, 0.66-1.3) or between prognosis and primary PCI in STEACS (HR=1; 95% CI, 0.7-1.5). Findings for mortality and rehospitalization for ACS at 6 months were similar. CONCLUSIONS: Data for 2004-2005 demonstrated a marked increase in the use of invasive procedures. However, the procedures employed were poorly matched to the patients' baseline risk.
INTRODUCTION AND OBJECTIVES: To investigate the clinical characteristics and treatment of acute coronary syndromes (ACS), and to determine the effects of an early invasive strategy (EIS) in non-ST-elevation ACS (NSTEACS) and of primary percutaneous coronary intervention (PCI) in ST-elevation ACS (STEACS). METHODS: Data were collected prospectively for 9 months during 2004-2005 from 50 hospitals, which were randomly selected according to the level of care provided. In addition, follow-up data on mortality and readmission for ACS were collected for 6 months. The adjusted effects of different reperfusion strategies were analyzed. RESULTS: After checking data quality, the analysis included data from 32 hospitals, which covered 7923 coronary events (4431 [56%] STEACS, 3034 [38%] NSTEACS and 458 [6%] unclassified ACS) in 7251 patients. Compared with previous studies, the use of primary PCI in STEACS had increased markedly (from 10.7% to 36.8% of patients undergoing reperfusion), as had the use of EIS in NSTEACS (from 11.1% to 19.6%). Overall in-hospital mortality was 5.7% (95% confidence interval [CI], 5.1%-6.2%); for STEACS it was 7.6% (95% CI, 6.7%-8.7%), for NSTEACS 3.9% (95% CI, 3.3%-4.6%), and for unclassified ACS 8.8% (95% CI, 6.2%-12.2%). In the population as a whole, there was no association between prognosis (i.e., 6-month mortality) and EIS in NSTEACS (hazard ratio [HR]=0.94; 95% CI, 0.66-1.3) or between prognosis and primary PCI in STEACS (HR=1; 95% CI, 0.7-1.5). Findings for mortality and rehospitalization for ACS at 6 months were similar. CONCLUSIONS: Data for 2004-2005 demonstrated a marked increase in the use of invasive procedures. However, the procedures employed were poorly matched to the patients' baseline risk.
Authors: Juan Sanchis; Julio Núñez; Vicente Bodí; Eduardo Núñez; Ana García-Alvarez; Clara Bonanad; Ander Regueiro; Xavier Bosch; Magda Heras; Joan Sala; Oscar Bielsa; Angel Llácer Journal: Mayo Clin Proc Date: 2011-02-23 Impact factor: 7.616
Authors: Francisco Javier Félix-Redondo; Luis Lozano Mera; Luciano Consuegra-Sánchez; Fernando Giménez Sáez; Francisco Javier Garcipérez de Vargas; José María Castellano Vázquez; Daniel Fernández-Bergés Journal: Open Heart Date: 2016-02-26
Authors: Ander Regueiro; Julia Bosch; Victoria Martín-Yuste; Alba Rosas; Maria Teresa Faixedas; Joan Antoni Gómez-Hospital; Jaume Figueras; Antoni Curós; Angel Cequier; Javier Goicolea; Antonio Fernández-Ortiz; Carlos Macaya; Ricard Tresserras; Laura Pellisé; Manel Sabaté Journal: BMJ Open Date: 2015-12-09 Impact factor: 2.692
Authors: Franz Goss; Johannes Brachmann; Christian W Hamm; Winfried Haerer; Nicolaus Reifart; Benny Levenson Journal: Vasc Health Risk Manag Date: 2017-04-06
Authors: Daniel Fernández-Bergés; Irene R Degano; Reyes Gonzalez Fernandez; Isaac Subirana; Joan Vila; Manuel Jiménez-Navarro; Silvia Perez-Fernandez; Mercé Roqué; Antoni Bayes-Genis; Francisco Fernandez-Aviles; Antonio Mayorga; Vicente Bertomeu-Gonzalez; Juan Sanchis; Marcos Rodríguez Esteban; Antonio Sanchez-Hidalgo; Esther Sanchez-Insa; Ane Elorriaga; Emad Abu Assi; Alberto Nuñez; Jose Manuel Garcia Ruiz; Pedro Morrondo Valdeolmillos; Daniel Bosch-Portell; Iñaki Lekuona; Andres Carrillo-Lopez; Alberto Zamora; Berta Vega-Hernandez; Javier Alameda Serrano; Catalina Rubert; Luis Ruiz-Valdepeñas; Laura Quintas; Luis Rodríguez-Padial; Jessica Vaquero; Luis Martinez Dolz; Jose A Barrabes; Pedro L Sanchez; Alessandro Sionis; Julio Martí-Almor; Roberto Elosua; Rosa-María Lidon; David Garcia-Dorado; Jaume Marrugat Journal: Open Heart Date: 2020-08