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A multicentre retrospective study to understand anti-platelet treatment patterns and outcomes of acute coronary syndrome patients in India (TRACE).
Indian Heart J. 2014 May-Jun; 66(3):334-9.IH

Abstract

BACKGROUND

There is limited available information for treatment of acute coronary syndrome (ACS) with respect to outcomes, therapeutic agents and treatment practices. Our retrospective registry study collected and evaluated varying anti-platelet treatment strategies and outcomes of ACS patients who were admitted to 9 different tertiary care hospitals in India. This study was carried out to provide an insight to anti-platelet treatment patterns and analyze outcomes of ACS patients in India.

METHODS

All the relevant data, including anti-platelet treatment strategies, outcomes and patient treatment compliance were collected from 500 ACS (defined as STEMI, NSTEMI and unstable angina [UA]) cases from January 2007 to December 2009. These ACS cases were randomly collected from the hospital records and included in the analysis. The patient follow up data was acquired either from the hospital records or via telephonic contact for a period of one year following the event.

RESULTS

Out of 500 ACS patients, 59.8% had UA/NSTEMI and 40.2% had STEMI. On hospital admission, aspirin, clopidogrel, statins, beta-blockers and angiotensin converting enzyme inhibitors (ACE-Is) were used by 83%, 83%, 68%, 43.2% and 31.6% patients, respectively. On discharge, aspirin, clopidogrel, statins and beta-blockers were used by 90.2%, 88%, 80.6%, and 59% patients, respectively. The average patient compliance to statins, clopidogrel and aspirin was recorded as 74.28%, 69.7% and 68.66%, respectively during discharge and follow-up visits. Greater than 50% of ACS patients after discharge were lost to follow-up and as a result there was significant drop in the number of clinical events reported.

CONCLUSION

This pilot study conducted in tertiary care centers in India showed that patients with ACS were more often diagnosed with UA/NSTEMI as compared to STEMI and reported maximum compliance to statins, clopidogrel and aspirin after discharge over 1 year follow-up. More ACS patients were lost to follow up that resulted in low reporting of clinical outcomes, following discharge upto 1 year.

Authors+Show Affiliations

Executive Director and Dean Cardiology, Escorts Heart Institute and Fortis Group of Hospitals, Okhla, New Delhi 110025, India. Electronic address: Kaul.upendra@gmail.com.Chairman and Managing Director, Director of Cardiology, Delhi Heart and Lung Institute, Panchkuian Road, New Delhi, India.Director, Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital, Four Bungalows, Andheri (W), Mumbai 400053, Maharashtra, India.Chairman, Care Institute of Medical Sciences and Hospital, Off Science City Road, Sola, Ahmedabad 380060, Gujarat, India.Director, Cath Lab, Ruby Hall Clinic, Sasoon Road, Pune 411001, Maharashtra, India.Director, Cardiology, Madras Medical Mission, J.J. Nagar, Mogappair, Chennai 600037, Tamil Nadu, India.Head of the Dept, Cardiology, TRS Hospital, Trivandrum, Kerala, India.Associate Professor, Department of Cardiology, GGS Medical College, Faridkot 151203, Punjab, India.Vice President, Medical Affairs & Regulatory, AstraZeneca Pharma India Ltd. 'Avishkar', P.B. No. 2483, Off Bellary Road, Hebbal, Bangalore 560024, Karnataka, India.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

24973840

Citation

Kaul, Upendra, et al. "A Multicentre Retrospective Study to Understand Anti-platelet Treatment Patterns and Outcomes of Acute Coronary Syndrome Patients in India (TRACE)." Indian Heart Journal, vol. 66, no. 3, 2014, pp. 334-9.
Kaul U, Sethi KK, Dalal J, et al. A multicentre retrospective study to understand anti-platelet treatment patterns and outcomes of acute coronary syndrome patients in India (TRACE). Indian Heart J. 2014;66(3):334-9.
Kaul, U., Sethi, K. K., Dalal, J., Parikh, K., Hiremath, M. S., Mullasari, A. S., Nair, T., Sandhu, P. S., & Kotak, B. (2014). A multicentre retrospective study to understand anti-platelet treatment patterns and outcomes of acute coronary syndrome patients in India (TRACE). Indian Heart Journal, 66(3), 334-9. https://doi.org/10.1016/j.ihj.2014.03.009
Kaul U, et al. A Multicentre Retrospective Study to Understand Anti-platelet Treatment Patterns and Outcomes of Acute Coronary Syndrome Patients in India (TRACE). Indian Heart J. 2014 May-Jun;66(3):334-9. PubMed PMID: 24973840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multicentre retrospective study to understand anti-platelet treatment patterns and outcomes of acute coronary syndrome patients in India (TRACE). AU - Kaul,Upendra, AU - Sethi,K K, AU - Dalal,Jamshed, AU - Parikh,Keyur, AU - Hiremath,M S, AU - Mullasari,Ajit S, AU - Nair,Tiny, AU - Sandhu,P S, AU - Kotak,Bhavesh, Y1 - 2014/04/16/ PY - 2013/07/05/received PY - 2013/08/21/revised PY - 2014/03/23/accepted PY - 2014/6/30/entrez PY - 2014/6/30/pubmed PY - 2015/10/17/medline KW - Acute coronary syndrome KW - Non-ST elevation myocardial infarction KW - ST-elevation myocardial infarction KW - Unstable angina SP - 334 EP - 9 JF - Indian heart journal JO - Indian Heart J VL - 66 IS - 3 N2 - BACKGROUND: There is limited available information for treatment of acute coronary syndrome (ACS) with respect to outcomes, therapeutic agents and treatment practices. Our retrospective registry study collected and evaluated varying anti-platelet treatment strategies and outcomes of ACS patients who were admitted to 9 different tertiary care hospitals in India. This study was carried out to provide an insight to anti-platelet treatment patterns and analyze outcomes of ACS patients in India. METHODS: All the relevant data, including anti-platelet treatment strategies, outcomes and patient treatment compliance were collected from 500 ACS (defined as STEMI, NSTEMI and unstable angina [UA]) cases from January 2007 to December 2009. These ACS cases were randomly collected from the hospital records and included in the analysis. The patient follow up data was acquired either from the hospital records or via telephonic contact for a period of one year following the event. RESULTS: Out of 500 ACS patients, 59.8% had UA/NSTEMI and 40.2% had STEMI. On hospital admission, aspirin, clopidogrel, statins, beta-blockers and angiotensin converting enzyme inhibitors (ACE-Is) were used by 83%, 83%, 68%, 43.2% and 31.6% patients, respectively. On discharge, aspirin, clopidogrel, statins and beta-blockers were used by 90.2%, 88%, 80.6%, and 59% patients, respectively. The average patient compliance to statins, clopidogrel and aspirin was recorded as 74.28%, 69.7% and 68.66%, respectively during discharge and follow-up visits. Greater than 50% of ACS patients after discharge were lost to follow-up and as a result there was significant drop in the number of clinical events reported. CONCLUSION: This pilot study conducted in tertiary care centers in India showed that patients with ACS were more often diagnosed with UA/NSTEMI as compared to STEMI and reported maximum compliance to statins, clopidogrel and aspirin after discharge over 1 year follow-up. More ACS patients were lost to follow up that resulted in low reporting of clinical outcomes, following discharge upto 1 year. SN - 2213-3763 UR - https://www.unboundmedicine.com/medline/citation/24973840/A_multicentre_retrospective_study_to_understand_anti_platelet_treatment_patterns_and_outcomes_of_acute_coronary_syndrome_patients_in_India__TRACE__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0019-4832(14)00123-0 DB - PRIME DP - Unbound Medicine ER -