Petr Tousek1, Frantisek Tousek2, David Horak3, Pavel Cervinka4, Richard Rokyta5, Ladislav Pesl2, Jiri Jarkovsky6, Petr Widimsky7. 1. Cardiocenter, Charles University Prague, Third Faculty of Medicine, Prague, Czech Republic. 2. Regional Hospital, Department of Cardiology, Ceske Budejovice, Czech Republic. 3. Cardiocenter, Hospital Liberec, Liberec, Czech Republic. 4. Masaryk Hospital, Department of Cardiology, Usti nad Labem, Czech Republic. 5. University Hospital Plzen, Faculty of Medicine Plzen, Charles University, Dept. of Cardiology, Plzen, Czech Republic. 6. Masaryk University, Faculty of Medicine, Institute for Biostatistics and Analysis, Brno, Czech Republic. 7. Cardiocenter, Charles University Prague, Third Faculty of Medicine, Prague, Czech Republic. Electronic address: petr.widimsky@fnkv.cz.
Abstract
BACKGROUND: The incidence and treatment strategies of acute coronary syndrome (ACS) vary by region. Additionally, the clinical spectrum of ACS is changing and outcomes are improving. AIM: We assessed the incidence, treatment strategies, and outcomes of ACS for a well-defined population within a well-established network of percutaneous coronary intervention (PCI) centers and non-PCI centers. METHODS: The CZECH-2 registry included 1221 consecutive patients (mean age: 68 ± 13 years; 63.4% males) admitted for suspected ACS to 32 hospitals (including 4 PCI centers) within four Czech counties (total population: 2,370,841 inhabitants) during a 2-month period. RESULTS: The estimated incidence of confirmed ACS was 2,149 cases/million/year. In 374 (31%) patients, ACS was ruled out during the hospital stay. Coronary angiography (CAG) was performed in 60% of the patients overall and PCI was performed in 59% of the confirmed ACS patients. Killip classifications II-IV on admission were more common in patients with final diagnosis of non ST-elevation myocardial infarction (NSTEMI) than ST-elevation myocardial infarction (STEMI) (37.1% vs. 22.8%; p<0.001). The 30-day mortality rate was 5.7% for the whole study group, 7.3% for STEMI patients, 8.4% for NSTEMI patients, and 1.6% for patients with unstable angina pectoris (UAP), respectively. CONCLUSIONS: Almost one-third of the patients admitted for suspected ACS had a different final diagnosis. Among those with confirmed ACS, the use of CAG, PCI, CABG, and effective medications is rational. Outcome in NSTEMI patients was equivalent to those in STEMI patients, mainly due to the high-risk population in this group.
BACKGROUND: The incidence and treatment strategies of acute coronary syndrome (ACS) vary by region. Additionally, the clinical spectrum of ACS is changing and outcomes are improving. AIM: We assessed the incidence, treatment strategies, and outcomes of ACS for a well-defined population within a well-established network of percutaneous coronary intervention (PCI) centers and non-PCI centers. METHODS: The CZECH-2 registry included 1221 consecutive patients (mean age: 68 ± 13 years; 63.4% males) admitted for suspected ACS to 32 hospitals (including 4 PCI centers) within four Czech counties (total population: 2,370,841 inhabitants) during a 2-month period. RESULTS: The estimated incidence of confirmed ACS was 2,149 cases/million/year. In 374 (31%) patients, ACS was ruled out during the hospital stay. Coronary angiography (CAG) was performed in 60% of the patients overall and PCI was performed in 59% of the confirmed ACS patients. Killip classifications II-IV on admission were more common in patients with final diagnosis of non ST-elevation myocardial infarction (NSTEMI) than ST-elevation myocardial infarction (STEMI) (37.1% vs. 22.8%; p<0.001). The 30-day mortality rate was 5.7% for the whole study group, 7.3% for STEMI patients, 8.4% for NSTEMI patients, and 1.6% for patients with unstable angina pectoris (UAP), respectively. CONCLUSIONS: Almost one-third of the patients admitted for suspected ACS had a different final diagnosis. Among those with confirmed ACS, the use of CAG, PCI, CABG, and effective medications is rational. Outcome in NSTEMI patients was equivalent to those in STEMI patients, mainly due to the high-risk population in this group.
Authors: Petr Toušek; David Bauer; Marek Neuberg; Markéta Nováčková; Petr Mašek; Petr Tu Ma; Viktor Kočka; Zuzana Moťovská; Petr Widimský Journal: Eur Heart J Suppl Date: 2022-03-30 Impact factor: 1.624