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The incidence and outcomes of acute coronary syndromes in a central European country: Results of the CZECH-2 registry

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TOUSEK Petr TOUSEK Frantisek HORAK David CERVINKA Pavel ROKYTA Richard PESL Ladislav JARKOVSKÝ Jiří WIDIMSKÝ Petr

Rok publikování 2014
Druh Článek v odborném periodiku
Časopis / Zdroj International Journal of Cardiology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.1016/j.ijcard.2014.02.013
Obor Kardiovaskulární nemoci včetně kardiochirurgie
Klíčová slova Acute coronary syndrome; Registry; Outcome; Incidence
Popis 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 2149 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 PCIwas performed in 59% of the confirmed ACS patients. Killip classifications II-IV on admissionweremore common in patientswith final diagnosis of non ST-elevationmyocardial infarction (NSTEMI) than ST-elevationmyocardial infarction (STEMI) (37.1% vs. 22.8%; p b 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.

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