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- Title
Indikujeme adekvátne invazívnu diagnostiku u pacientov s NSTE-AKS? Analýza výsledkov registra SLOVAKS-2 z roku 2015.
- Authors
F., Kovář; M., Studenčan; R., Alberty; V., Hricák; P., Kurray; G., Kamenský; I., Šimková; R., Hatala
- Abstract
Introduction: Data collection and subsequent analysis on patients with acute coronary syndrome without ST segment elevation (NSTE-ACS) in the Slovak Republic is provided to the SLOVACS registry, which comprehensively evaluates management of the NSTE-ACS patients. Objective: Analysis and evaluation of data from hospitalized patients with NSTE-ACS, assessment of non-invasive and invasive management, and implementation of guidelines in clinical practice. Methodology: Collected data from patients hospitalized with diagnosis of NSTE-ACS were reported during 2 months (February and March, 2015). Selected indicators were assessed: risk profile, anamnestic data, complex pharmacological treatment, indication for invasive diagnosis and subsequent coronary artery revascularisation. The analysis was performed in the entire group of NSTE-ACS as well as prespecified subgroup according to gender and presence or absence of diabetes mellitus. These results were compared with data from the previous SLOVAKS 2007 and 2008 and the SLOVAKS-2 in 2011 year registries. Results: Data were analyzed from 1 123 patients with NSTE-ACS, 682 men (mean age 65.4 ± 10.9 year) and 441 women (mean age 70.9 ± 10.2 year). There were 502 patients hospitalized with diagnosis of unstable angina (UA) and 621 patients with myocardial infarction without ST segment elevation (NSTEMI). Among patients with NSTEMI and UA a high incidence of hypertension (88.8% and 87.1%, respectively), diabetes mellitus (31.3% and 38.6%, respectively) and hypercholesterolemia (68.7% and 63.9%, respectively) were observed. A high proportion of NSTE-ACS patients (80-90%) have been treated with a complex recommended pharmacotherapy (dual antiplatelet therapy and parenteral anticoagulants, statins, beta blockers, ACE inhibitors/sartans). The invasive diagnosis of coronary arteries was performed in 67.7% patients in the UA group and in 62.0% among NSTEMI patients. Subsequent intervention therapy has been practised in 37.8% patients with UA and 33.8% in NSTEMI, respectively. Cardiac surgery procedure was performed on 5.0% patients with UA and 8.4% with NSTEMI. Moreover, 7.0% and 5.2% with UA and NSTEMI, respectively, have been planned for elective bypass grafting. 64.4% patients, hospitalized with diagnosis of NSTE-ACS in six cardiocenters in Slovakia were reported (of witch 55.3% underwent intervention therapy). Mortality rate during index hospitalization in NSTEACS patients was 3.6%, in the UA group 0,4% and in NSTEMI patients 6.25%. However, in early invasively managed NSTEMI patients, mortality rate reached only 1%. Conclusion: The results of the SLOVACS-2 registry from 2015 document a high quality level according to recommendations for complex pharmacotherapy of NSTE-ACS. The lower proportion of the NSTE-ACS patients reported from hospitals with invasive facilities had an effect on the indication for early coronary angiography and subsequent coronary artery revascularization.
- Publication
Cardiology Letters, 2017, Vol 26, Issue 2, p69
- ISSN
1338-3655
- Publication type
Article