Yi-Heng Li1, Yu-Wei Chiu2, Jun-Jack Cheng3, I-Chang Hsieh4, Ping-Han Lo5, Meng-Huan Lei6, Kwo-Chang Ueng7, Fu-Tien Chiang8, Shih-Hsien Sung9, Jen-Yuan Kuo10, Ching-Pei Chen11, Wen-Ter Lai12, Wen-Lieng Lee13, Jyh-Hong Chen14. 1. National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan. 2. Far Eastern Memorial Hospital, New Taipei City. 3. Shin Kong Wu Ho-Su Memorial Hospital, Taipei. 4. Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan. 5. China Medical University Hospital and College of Medicine, Taichung. 6. Lotung Poh-Ai Hospital, Lotung. 7. Chung Shan Medical University Hospital, Taichung. 8. National Taiwan University Hospital and Fu-Jen Catholic University Hospital. 9. Taipei Veterans General Hospital and National Yang Ming University. 10. Mackay Memorial Hospital, Taipei. 11. Changhua Christian Hospital, Changhua. 12. Kaohsiung Medical University Hospital, Kaohsiung City. 13. Taichung Veterans General Hospital. 14. College of Medicine, China Medical University, Taichung, Taiwan.
Abstract
BACKGROUND: Patients with acute coronary syndrome (ACS), including ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation (NSTE)-ACS have a significant risk of morbidity and mortality. This study evaluated the practice patterns of ACS care in Taiwan from 2005 to 2018. METHODS: Data from two nationwide ACS registries (2008-2010 and 2012-2015) were used. ACS patients who received percutaneous coronary interventions (PCIs) during admission were compared between the two registries. RESULTS: In STEMI, the door-to-balloon time for primary PCI decreased by 25 min from a median of 96 to 71 min (p < 0.0001) from the first to second registry. More complex PCI procedures and drug-eluting stents were used for ACS. However, the onset-to-door time was still long for both STEMI and NSTE-ACS. The D2B time for NSTE-ACS was long, especially in the elderly and female patients. Although the prescription rate of secondary preventive medications for ACS increased, it was still relatively low compared with Western data, especially in NSTE-ACS. CONCLUSIONS: The registry data showed that ACS care quality has improved in Taiwan. However, areas including onset-to-door time and use of secondary preventive medications still need further improvements.
BACKGROUND: Patients with acute coronary syndrome (ACS), including ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation (NSTE)-ACS have a significant risk of morbidity and mortality. This study evaluated the practice patterns of ACS care in Taiwan from 2005 to 2018. METHODS: Data from two nationwide ACS registries (2008-2010 and 2012-2015) were used. ACS patients who received percutaneous coronary interventions (PCIs) during admission were compared between the two registries. RESULTS: In STEMI, the door-to-balloon time for primary PCI decreased by 25 min from a median of 96 to 71 min (p < 0.0001) from the first to second registry. More complex PCI procedures and drug-eluting stents were used for ACS. However, the onset-to-door time was still long for both STEMI and NSTE-ACS. The D2B time for NSTE-ACS was long, especially in the elderly and female patients. Although the prescription rate of secondary preventive medications for ACS increased, it was still relatively low compared with Western data, especially in NSTE-ACS. CONCLUSIONS: The registry data showed that ACS care quality has improved in Taiwan. However, areas including onset-to-door time and use of secondary preventive medications still need further improvements.
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