In-hospital acute coronary syndrome management in Europe: Pharmacological treatment trends, adequacy to the latest guidelines and its impact on vital status at discharge - 05/01/18
, I. Roman Dégano 2, I. Kirschberger 3, D. Farmakis 4, L. Tavazzi 5, J. Marrugat 2, J. Ferrières 6Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Résumé |
Background |
Acute coronary syndrome (ACS) early management can be decisive and is subject to guidelines.
Purpose |
To describe the variations of in-hospital pharmacological treatments of ACS patients in Europe over time, to describe the adequacy of the in-hospital pharmacological treatments of ACS patients with the latest ESC guidelines (2012 and 2015 ESC guidelines for STEACS and non-STEACS patients respectively), and to assess the link between treatment adequacy with guidelines and vital status at discharge.
Methods |
EUROTRACS (EUROpean Treatment & Reduction of Acute Coronary Syndromes cost analysis) database was created by merging data from European studies and surveys, national/regional clinical registries of ASC patients. Beta-blockers, statins, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB), and aspirin were considered. The analyses were performed separately for STEACS and non-STEACS patients.
Results |
Due to missing data regarding the variables of interest (>20%), only data from the Euro Heart Surveys I and II, the Greek, German and Spanish registries (respectively HELIOS, MONICA/KORA MI, MASCARA) have been used. Aspirin appeared to be steadily prescribed (91.2% in 2000 and 97.9% of ACS patients treated in 2010). Beta-blockers, statins and ACEI/ARB prescriptions have increased (Fig. 1). Regarding adequacy to the guidelines, beta-blockers and statins seemed to be better prescribed over time whereas ACEI/ARB prescription adequacy decreased (but this comparison was partial since some patient's parameters, such as intolerance to statins or to ACEI, were not available). Same trends were observed in STEACS and non-STEACS patients. The final analyses are still in progress.
Conclusion |
Prescription of pharmacological treatment in ACS patients varied over time as well as the respect of the recommendations.
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Vol 10 - N° 1
P. 10-11 - janvier 2018 Retour au numéro
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