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Polish Registry of Acute Coronary Syndromes (PL-ACS). Characteristics, treatments and outcomes of patients with acute coronary syndromes in Poland.
Kardiol Pol. 2007 Aug; 65(8):861-72; discussion 873-4.KP

Abstract

BACKGROUND

In Poland, together with the transformation of the political system, significant positive changes have been made to the national health care system. This provided a possibility for hospitals to apply current standards of care to patients with acute coronary syndromes (ACS).

AIM

To assess contemporary data on epidemiology, management and outcomes of patients with ACS in Poland, and to evaluate adherence to the guidelines' recommended treatment.

METHODS

We performed an observational study of 100,193 patients hospitalised due to unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), or ST-segment elevation myocardial infarction (STEMI), prospectively enrolled in 417 hospitals from October 2003 to March 2006 in the ongoing Polish Registry of Acute Coronary Syndromes (PL-ACS). The registry is carried out in cooperation with the Ministry of Health and the National Health Fund.

RESULTS

The initial diagnoses were unstable angina in 42.2%, NSTEMI in 26.6%, and STEMI in 31.2% of patients. About one-third of patients were treated outside of cardiology departments (mainly in the internal medicine wards). In patients without ST elevation, invasive strategy (early coronary angiography) was used with almost equal frequency in unstable angina (29.4%) and NSTEMI (31.7%). However, in-hospital mortality was low in unstable angina (0.8%), being much higher in NSTEMI patients (6.6%), (p<0.001). In STEMI reperfusion therapy was administered in 63.3% of patients (thrombolysis 7.8%, primary PCI 54.1%, and PCI after thrombolysis 1.4%). In-hospital mortality in STEMI was 9.3%. Median times from the onset of symptoms to invasive treatment were: 37 hours in unstable angina, 23 hours in NSTEMI, and 5 hours in STEMI. The guidelines' recommended pharmacotherapy was used in a high percentage of patients except for thienopyridines and GP IIb/IIIa inhibitors.

CONCLUSIONS

The Polish Registry of Acute Coronary Syndromes shows several discrepancies between guidelines' recommended treatment and their utilisation in everyday practice. Particularly, the under-utilisation of invasive treatment in patients with NSTEMI is alarming. Efforts should be made to increase the usage of invasive treatment in NSTEMI patients and to shorten the delay from the symptom onset to intervention.

Authors+Show Affiliations

Silesian Centre for Heart Diseases, Zabrze, Poland. scchs@sum.edu.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17853315

Citation

Poloński, Lech, et al. "Polish Registry of Acute Coronary Syndromes (PL-ACS). Characteristics, Treatments and Outcomes of Patients With Acute Coronary Syndromes in Poland." Kardiologia Polska, vol. 65, no. 8, 2007, pp. 861-72; discussion 873-4.
Poloński L, Gasior M, Gierlotka M, et al. Polish Registry of Acute Coronary Syndromes (PL-ACS). Characteristics, treatments and outcomes of patients with acute coronary syndromes in Poland. Kardiol Pol. 2007;65(8):861-72; discussion 873-4.
Poloński, L., Gasior, M., Gierlotka, M., Kalarus, Z., Cieśliński, A., Dubiel, J. S., Gil, R. J., Ruzyłło, W., Trusz-Gluza, M., Zembala, M., & Opolski, G. (2007). Polish Registry of Acute Coronary Syndromes (PL-ACS). Characteristics, treatments and outcomes of patients with acute coronary syndromes in Poland. Kardiologia Polska, 65(8), 861-72; discussion 873-4.
Poloński L, et al. Polish Registry of Acute Coronary Syndromes (PL-ACS). Characteristics, Treatments and Outcomes of Patients With Acute Coronary Syndromes in Poland. Kardiol Pol. 2007;65(8):861-72; discussion 873-4. PubMed PMID: 17853315.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polish Registry of Acute Coronary Syndromes (PL-ACS). Characteristics, treatments and outcomes of patients with acute coronary syndromes in Poland. AU - Poloński,Lech, AU - Gasior,Mariusz, AU - Gierlotka,Marek, AU - Kalarus,Zbigniew, AU - Cieśliński,Andrzej, AU - Dubiel,Jacek S, AU - Gil,Robert J, AU - Ruzyłło,Witold, AU - Trusz-Gluza,Maria, AU - Zembala,Marian, AU - Opolski,Grzegorz, PY - 2007/9/14/pubmed PY - 2008/1/4/medline PY - 2007/9/14/entrez SP - 861-72; discussion 873-4 JF - Kardiologia polska JO - Kardiol Pol VL - 65 IS - 8 N2 - BACKGROUND: In Poland, together with the transformation of the political system, significant positive changes have been made to the national health care system. This provided a possibility for hospitals to apply current standards of care to patients with acute coronary syndromes (ACS). AIM: To assess contemporary data on epidemiology, management and outcomes of patients with ACS in Poland, and to evaluate adherence to the guidelines' recommended treatment. METHODS: We performed an observational study of 100,193 patients hospitalised due to unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), or ST-segment elevation myocardial infarction (STEMI), prospectively enrolled in 417 hospitals from October 2003 to March 2006 in the ongoing Polish Registry of Acute Coronary Syndromes (PL-ACS). The registry is carried out in cooperation with the Ministry of Health and the National Health Fund. RESULTS: The initial diagnoses were unstable angina in 42.2%, NSTEMI in 26.6%, and STEMI in 31.2% of patients. About one-third of patients were treated outside of cardiology departments (mainly in the internal medicine wards). In patients without ST elevation, invasive strategy (early coronary angiography) was used with almost equal frequency in unstable angina (29.4%) and NSTEMI (31.7%). However, in-hospital mortality was low in unstable angina (0.8%), being much higher in NSTEMI patients (6.6%), (p<0.001). In STEMI reperfusion therapy was administered in 63.3% of patients (thrombolysis 7.8%, primary PCI 54.1%, and PCI after thrombolysis 1.4%). In-hospital mortality in STEMI was 9.3%. Median times from the onset of symptoms to invasive treatment were: 37 hours in unstable angina, 23 hours in NSTEMI, and 5 hours in STEMI. The guidelines' recommended pharmacotherapy was used in a high percentage of patients except for thienopyridines and GP IIb/IIIa inhibitors. CONCLUSIONS: The Polish Registry of Acute Coronary Syndromes shows several discrepancies between guidelines' recommended treatment and their utilisation in everyday practice. Particularly, the under-utilisation of invasive treatment in patients with NSTEMI is alarming. Efforts should be made to increase the usage of invasive treatment in NSTEMI patients and to shorten the delay from the symptom onset to intervention. SN - 0022-9032 UR - https://www.unboundmedicine.com/medline/citation/17853315/Polish_Registry_of_Acute_Coronary_Syndromes__PL_ACS___Characteristics_treatments_and_outcomes_of_patients_with_acute_coronary_syndromes_in_Poland_ DB - PRIME DP - Unbound Medicine ER -