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Guideline-adherent therapy in patients with acute coronary syndromes. The EPICOR registry in Germany.
Herz. 2015 Mar; 40 Suppl 1:27-35.HERZ

Abstract

BACKGROUND

Representative data on the current management of patients with acute coronary syndromes (ACS) are of high interest. The EPICOR registry aimed to prospectively collect such real-life data with particular focus on antithrombotic drug utilization and outcomes.

METHODS

As part of the international prospective EPICOR registry, 29 hospitals in Germany documented 296 patients with ST-elevation myocardial infarction (STEMI)-ACS and 333 with unstable angina or non-STEMI (NSTEMI)-ACS surviving the hospital phase. The statistical analysis was performed in a descriptive manner. The ClinicalTrials.gov identifier is NCT01171404.

RESULTS

The mean age of patients was 62 ± 13 years, and 77.4 % were men. Treatment with antithrombotic agents was initiated in the prehospital phase in 50.7 % of STEMI and 33.3 % of NSTEMI patients. During the hospital stay (median 7.0 days), cardiac catheterization was performed in 97.6 %, percutaneous coronary intervention in 85.6 %, thrombolysis in 4.6 %, and coronary bypass surgery in 2.7 % patients. The use of acetylic salicylic acid (ASA) was reported in 95.6 % vs. 96.1 %, clopidogrel in 60.8 % vs. 73.0 %, prasugrel in 45.6 % vs. 22.5 %, any GP IIb/IIIa inhibitor in 52.4 % vs. 18.9 % [any dual combination of ASA+(clopidogrel/prasugrel)in 94.0 vs. 91.0 %], statins in 94.6 % vs. 92.2 %, beta blockers in 96.3 % vs. 94.6 %, and ACE-I/ARB in 91.6 % vs. 87.7 % of STEMI vs. NSTEMI patients, respectively. Combined use of the five drug classes recommended in the guidelines-ASA, P2Y12 antagonists, statin, beta blocker, and ACE-I/ARB-was reported in 81.1 % vs. 69.4 % of STEMI vs. NSTEMI patients, respectively.

CONCLUSION

In Germany a high proportion of patients with ACS are treated according to current guidelines, receiving primary revascularization as well as antithrombotic drugs and other agents for prevention of secondary events; associated bleeding complications were less frequent as compared with published registries.

Authors+Show Affiliations

Klinikum Ludwigshafen, Bremser Str. 79, 67063, Ludwigshafen, Germany, Uwe.Zeymer@t-online.de.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25374386

Citation

Zeymer, U, et al. "Guideline-adherent Therapy in Patients With Acute Coronary Syndromes. the EPICOR Registry in Germany." Herz, vol. 40 Suppl 1, 2015, pp. 27-35.
Zeymer U, Heuer H, Schwimmbeck P, et al. Guideline-adherent therapy in patients with acute coronary syndromes. The EPICOR registry in Germany. Herz. 2015;40 Suppl 1:27-35.
Zeymer, U., Heuer, H., Schwimmbeck, P., Genth-Zotz, S., Wolff, K., & Nienaber, C. A. (2015). Guideline-adherent therapy in patients with acute coronary syndromes. The EPICOR registry in Germany. Herz, 40 Suppl 1, 27-35. https://doi.org/10.1007/s00059-014-4161-7
Zeymer U, et al. Guideline-adherent Therapy in Patients With Acute Coronary Syndromes. the EPICOR Registry in Germany. Herz. 2015;40 Suppl 1:27-35. PubMed PMID: 25374386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Guideline-adherent therapy in patients with acute coronary syndromes. The EPICOR registry in Germany. AU - Zeymer,U, AU - Heuer,H, AU - Schwimmbeck,P, AU - Genth-Zotz,S, AU - Wolff,K, AU - Nienaber,C A, AU - ,, Y1 - 2014/11/07/ PY - 2014/06/17/received PY - 2014/09/25/accepted PY - 2014/08/25/revised PY - 2014/11/7/entrez PY - 2014/11/7/pubmed PY - 2015/12/15/medline SP - 27 EP - 35 JF - Herz JO - Herz VL - 40 Suppl 1 N2 - BACKGROUND: Representative data on the current management of patients with acute coronary syndromes (ACS) are of high interest. The EPICOR registry aimed to prospectively collect such real-life data with particular focus on antithrombotic drug utilization and outcomes. METHODS: As part of the international prospective EPICOR registry, 29 hospitals in Germany documented 296 patients with ST-elevation myocardial infarction (STEMI)-ACS and 333 with unstable angina or non-STEMI (NSTEMI)-ACS surviving the hospital phase. The statistical analysis was performed in a descriptive manner. The ClinicalTrials.gov identifier is NCT01171404. RESULTS: The mean age of patients was 62 ± 13 years, and 77.4 % were men. Treatment with antithrombotic agents was initiated in the prehospital phase in 50.7 % of STEMI and 33.3 % of NSTEMI patients. During the hospital stay (median 7.0 days), cardiac catheterization was performed in 97.6 %, percutaneous coronary intervention in 85.6 %, thrombolysis in 4.6 %, and coronary bypass surgery in 2.7 % patients. The use of acetylic salicylic acid (ASA) was reported in 95.6 % vs. 96.1 %, clopidogrel in 60.8 % vs. 73.0 %, prasugrel in 45.6 % vs. 22.5 %, any GP IIb/IIIa inhibitor in 52.4 % vs. 18.9 % [any dual combination of ASA+(clopidogrel/prasugrel)in 94.0 vs. 91.0 %], statins in 94.6 % vs. 92.2 %, beta blockers in 96.3 % vs. 94.6 %, and ACE-I/ARB in 91.6 % vs. 87.7 % of STEMI vs. NSTEMI patients, respectively. Combined use of the five drug classes recommended in the guidelines-ASA, P2Y12 antagonists, statin, beta blocker, and ACE-I/ARB-was reported in 81.1 % vs. 69.4 % of STEMI vs. NSTEMI patients, respectively. CONCLUSION: In Germany a high proportion of patients with ACS are treated according to current guidelines, receiving primary revascularization as well as antithrombotic drugs and other agents for prevention of secondary events; associated bleeding complications were less frequent as compared with published registries. SN - 1615-6692 UR - https://www.unboundmedicine.com/medline/citation/25374386/Guideline_adherent_therapy_in_patients_with_acute_coronary_syndromes__The_EPICOR_registry_in_Germany_ L2 - http://dx.doi.org/10.1007/s00059-014-4161-7 DB - PRIME DP - Unbound Medicine ER -