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Pre- and in-hospital antithrombotic management patterns and in-hospital outcomes in patients with acute coronary syndrome: data from the Turkish arm of the EPICOR study.
Anatol J Cardiol. 2016 12; 16(12):900-915.AJ

Abstract

OBJECTIVE

To evaluate the acute phase (pre- and in-hospital) antithrombotic management patterns (AMPs) and in-hospital outcomes for patients hospitalized with an acute coronary syndrome (ACS).

METHODS

In total, 1034 patients [514 patients with ST-segment elevation myocardial infarction (STEMI) and 520 with unstable angina/non-STEMI (UA/NSTEMI)] hospitalized for ACS within 24 h of symptom onset were included in this multicenter prospective registry study conducted at 34 hospitals across Turkey. Patient characteristics, index event description, pre- and in-hospital AMPs, and clinical outcomes were evaluated.

RESULTS

Majority (89.1%) of patients did not receive pre-hospital treatment. Overall 87.9% patients with STEMI and 55.6% patients with NSTEMI underwent percutaneous coronary intervention and dual antiplatelet therapy (DAPT) was based mainly on acetylsalicylic acid (ASA) and clopidogrel during hospitalization (99.8% and 98.2%, respectively). DAPT use at discharge was 98.4% and 86.8%, respectively. The percentage of patients with STEMI who received pre-hospital care, in-hospital cardiac catheterization, and pre and/or in-hospital triple antiplatelet therapy was higher than that of patients with UA/NSTEMI. In addition, higher rate of in-hospital hemorrhagic (2.3% vs. 0.8%) and cardiac ischemic (1.2% vs. 0.4% for MI and 1.6% vs. 0.8% for recurrent ischemia) complications and earlier induction of pre and/or in hospital antiplatelet therapy and cardiac catheterization were also noted in patients with STEMI than in those with UA/NSTEMI.

CONCLUSION

Our findings revealed in-hospital and at-discharge management to be mainly based on DAPT in patients with ACS. Interventional strategies were used in the majority of patients with STEMI, while the usage and timing of immediate pre-hospital ECG from symptom onset should be improved in these patients.

Authors+Show Affiliations

Department of Cardiology, Faculty of Medicine, Ankara University; Ankara-Turkey. fs.ertas@gmail.com.Department of Cardiology, Hacettepe University, Faculty of Medicine; Ankara-Turkey.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27443472

Citation

Ertaş, Fatih Sinan, et al. "Pre- and In-hospital Antithrombotic Management Patterns and In-hospital Outcomes in Patients With Acute Coronary Syndrome: Data From the Turkish Arm of the EPICOR Study." Anatolian Journal of Cardiology, vol. 16, no. 12, 2016, pp. 900-915.
Ertaş FS, Tokgözoğlu L, EPICOR Study Group. Pre- and in-hospital antithrombotic management patterns and in-hospital outcomes in patients with acute coronary syndrome: data from the Turkish arm of the EPICOR study. Anatol J Cardiol. 2016;16(12):900-915.
Ertaş, F. S., & Tokgözoğlu, L. (2016). Pre- and in-hospital antithrombotic management patterns and in-hospital outcomes in patients with acute coronary syndrome: data from the Turkish arm of the EPICOR study. Anatolian Journal of Cardiology, 16(12), 900-915. https://doi.org/10.14744/AnatolJCardiol.2016.6755
Ertaş FS, Tokgözoğlu L, EPICOR Study Group. Pre- and In-hospital Antithrombotic Management Patterns and In-hospital Outcomes in Patients With Acute Coronary Syndrome: Data From the Turkish Arm of the EPICOR Study. Anatol J Cardiol. 2016;16(12):900-915. PubMed PMID: 27443472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre- and in-hospital antithrombotic management patterns and in-hospital outcomes in patients with acute coronary syndrome: data from the Turkish arm of the EPICOR study. AU - Ertaş,Fatih Sinan, AU - Tokgözoğlu,Lale, AU - ,, Y1 - 2016/06/29/ PY - 2016/7/23/pubmed PY - 2018/11/13/medline PY - 2016/7/23/entrez SP - 900 EP - 915 JF - Anatolian journal of cardiology JO - Anatol J Cardiol VL - 16 IS - 12 N2 - OBJECTIVE: To evaluate the acute phase (pre- and in-hospital) antithrombotic management patterns (AMPs) and in-hospital outcomes for patients hospitalized with an acute coronary syndrome (ACS). METHODS: In total, 1034 patients [514 patients with ST-segment elevation myocardial infarction (STEMI) and 520 with unstable angina/non-STEMI (UA/NSTEMI)] hospitalized for ACS within 24 h of symptom onset were included in this multicenter prospective registry study conducted at 34 hospitals across Turkey. Patient characteristics, index event description, pre- and in-hospital AMPs, and clinical outcomes were evaluated. RESULTS: Majority (89.1%) of patients did not receive pre-hospital treatment. Overall 87.9% patients with STEMI and 55.6% patients with NSTEMI underwent percutaneous coronary intervention and dual antiplatelet therapy (DAPT) was based mainly on acetylsalicylic acid (ASA) and clopidogrel during hospitalization (99.8% and 98.2%, respectively). DAPT use at discharge was 98.4% and 86.8%, respectively. The percentage of patients with STEMI who received pre-hospital care, in-hospital cardiac catheterization, and pre and/or in-hospital triple antiplatelet therapy was higher than that of patients with UA/NSTEMI. In addition, higher rate of in-hospital hemorrhagic (2.3% vs. 0.8%) and cardiac ischemic (1.2% vs. 0.4% for MI and 1.6% vs. 0.8% for recurrent ischemia) complications and earlier induction of pre and/or in hospital antiplatelet therapy and cardiac catheterization were also noted in patients with STEMI than in those with UA/NSTEMI. CONCLUSION: Our findings revealed in-hospital and at-discharge management to be mainly based on DAPT in patients with ACS. Interventional strategies were used in the majority of patients with STEMI, while the usage and timing of immediate pre-hospital ECG from symptom onset should be improved in these patients. SN - 2149-2271 UR - https://www.unboundmedicine.com/medline/citation/27443472/Pre__and_in_hospital_antithrombotic_management_patterns_and_in_hospital_outcomes_in_patients_with_acute_coronary_syndrome:_data_from_the_Turkish_arm_of_the_EPICOR_study_ L2 - http://www.anatoljcardiol.com/linkout/?PMID=27443472 DB - PRIME DP - Unbound Medicine ER -