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Contemporary antithrombotic strategies in patients with acute coronary syndrome admitted to cardiac care units in Italy: The EYESHOT Study.
Eur Heart J Acute Cardiovasc Care. 2015 Oct; 4(5):441-52.EH

Abstract

BACKGROUND

Several new antithrombotic therapies have emerged for the treatment of acute coronary syndrome (ACS). We sought to assess contemporary patterns of antithrombotic therapies use in patients with ACS.

METHODS AND RESULTS

EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in patients admitted to intensive cardiac care units (CCUs) for an ACS in Italy. Over a three-week period, 203 CCUs enrolled 2585 consecutive patients: 41.2% with ST-elevation myocardial infarction (STEMI) and 58.8% with non-ST elevation ACS (NSTE-ACS). During hospitalisation, low-molecular-weight heparins, aspirin, and clopidogrel were the most commonly used antithrombotic therapies. Among patients treated with percutaneous coronary intervention (PCI, n=1755), any crossover of heparin therapy occurred in 30.8% of cases, while switching from one P2Y12 inhibitor to another occurred in 3.6% of cases in the CathLab and in 14.2% before discharge. Of the 790 patients who did not receive revascularisation, switching of a P2Y12 inhibitor occurred in 5.7% of cases. At discharge, a new P2Y12 inhibitor (ticagrelor or prasugrel) in association with aspirin was prescribed in 59.5% of STEMI and 33.9% of NSTE-ACS patients: the most powerful predictor for prescription was PCI (odds ratio (OR) 6.18; 95% confidence interval (CI) 4.76-8.01; p<0.0001), whereas age ≥ 75 years was strongly associated with clopidogrel use (OR 0.28; 95% CI 0.22-0.36; p<0.0001).

CONCLUSIONS

The EYESHOT registry shows the current pattern of antithrombotic treatments for ACS patients admitted to Italian CCUs and provides insights which may help to improve the clinical care of such patients.

Authors+Show Affiliations

Department of Cardiovascular Sciences, European Hospital, Italy leo.deluca@libero.it centrostudi@anmco.it.Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Italy.Division of Cardiology, Santa Maria della Misericordia Hospital, Italy.ANMCO Research Centre, Italy.Cardiovascular Department, AO Papa Giovanni XXIII, Italy.Division of Interventional Cardiology, Ospedale Civile dell'Annunziata, Italy.Division of Cardiology, S. Antonio Abate Hospital, Italy.Division of Cardiology, Maggiore della Carità Hospital, Italy.Division of Cardiology, Cattinara Hospital, Italy.Division of Cardiology, Garibaldi-Nesima Hospital, Italy.Cardiology Division, Campo di Marte Hospital, Italy.Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Italy.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

25414322

Citation

De Luca, Leonardo, et al. "Contemporary Antithrombotic Strategies in Patients With Acute Coronary Syndrome Admitted to Cardiac Care Units in Italy: the EYESHOT Study." European Heart Journal. Acute Cardiovascular Care, vol. 4, no. 5, 2015, pp. 441-52.
De Luca L, Leonardi S, Cavallini C, et al. Contemporary antithrombotic strategies in patients with acute coronary syndrome admitted to cardiac care units in Italy: The EYESHOT Study. Eur Heart J Acute Cardiovasc Care. 2015;4(5):441-52.
De Luca, L., Leonardi, S., Cavallini, C., Lucci, D., Musumeci, G., Caporale, R., Abrignani, M. G., Lupi, A., Rakar, S., Gulizia, M. M., Bovenzi, F. M., & De Servi, S. (2015). Contemporary antithrombotic strategies in patients with acute coronary syndrome admitted to cardiac care units in Italy: The EYESHOT Study. European Heart Journal. Acute Cardiovascular Care, 4(5), 441-52. https://doi.org/10.1177/2048872614560505
De Luca L, et al. Contemporary Antithrombotic Strategies in Patients With Acute Coronary Syndrome Admitted to Cardiac Care Units in Italy: the EYESHOT Study. Eur Heart J Acute Cardiovasc Care. 2015;4(5):441-52. PubMed PMID: 25414322.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contemporary antithrombotic strategies in patients with acute coronary syndrome admitted to cardiac care units in Italy: The EYESHOT Study. AU - De Luca,Leonardo, AU - Leonardi,Sergio, AU - Cavallini,Claudio, AU - Lucci,Donata, AU - Musumeci,Giuseppe, AU - Caporale,Roberto, AU - Abrignani,Maurizio G, AU - Lupi,Alessandro, AU - Rakar,Serena, AU - Gulizia,Michele M, AU - Bovenzi,Francesco M, AU - De Servi,Stefano, AU - ,, Y1 - 2014/11/20/ PY - 2014/08/20/received PY - 2014/10/18/accepted PY - 2014/11/22/entrez PY - 2014/11/22/pubmed PY - 2016/6/22/medline KW - Acute coronary syndrome KW - antithrombotic therapy KW - bivalirudin KW - heparins KW - prasugrel KW - ticagrelor SP - 441 EP - 52 JF - European heart journal. Acute cardiovascular care JO - Eur Heart J Acute Cardiovasc Care VL - 4 IS - 5 N2 - BACKGROUND: Several new antithrombotic therapies have emerged for the treatment of acute coronary syndrome (ACS). We sought to assess contemporary patterns of antithrombotic therapies use in patients with ACS. METHODS AND RESULTS: EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in patients admitted to intensive cardiac care units (CCUs) for an ACS in Italy. Over a three-week period, 203 CCUs enrolled 2585 consecutive patients: 41.2% with ST-elevation myocardial infarction (STEMI) and 58.8% with non-ST elevation ACS (NSTE-ACS). During hospitalisation, low-molecular-weight heparins, aspirin, and clopidogrel were the most commonly used antithrombotic therapies. Among patients treated with percutaneous coronary intervention (PCI, n=1755), any crossover of heparin therapy occurred in 30.8% of cases, while switching from one P2Y12 inhibitor to another occurred in 3.6% of cases in the CathLab and in 14.2% before discharge. Of the 790 patients who did not receive revascularisation, switching of a P2Y12 inhibitor occurred in 5.7% of cases. At discharge, a new P2Y12 inhibitor (ticagrelor or prasugrel) in association with aspirin was prescribed in 59.5% of STEMI and 33.9% of NSTE-ACS patients: the most powerful predictor for prescription was PCI (odds ratio (OR) 6.18; 95% confidence interval (CI) 4.76-8.01; p<0.0001), whereas age ≥ 75 years was strongly associated with clopidogrel use (OR 0.28; 95% CI 0.22-0.36; p<0.0001). CONCLUSIONS: The EYESHOT registry shows the current pattern of antithrombotic treatments for ACS patients admitted to Italian CCUs and provides insights which may help to improve the clinical care of such patients. SN - 2048-8734 UR - https://www.unboundmedicine.com/medline/citation/25414322/Contemporary_antithrombotic_strategies_in_patients_with_acute_coronary_syndrome_admitted_to_cardiac_care_units_in_Italy:_The_EYESHOT_Study_ L2 - http://journals.sagepub.com/doi/full/10.1177/2048872614560505?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -