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Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in Russia: an observational study (EPICOR-RUS study).
Curr Med Res Opin. 2017 07; 33(7):1269-1276.CM

Abstract

OBJECTIVE

This study sought to describe the short- and long-term (up to 2 years) antithrombotic management patterns in a real-life setting for patients hospitalized for an acute coronary syndrome (ACS) event, and to document clinical outcomes.

RESEARCH DESIGN AND METHODS

EPICOR-RUS was a multicenter (34 centers), prospective, observational, longitudinal cohort study conducted across Russia on antithrombotic management in hospitalized (within 24 hours of symptom onset) ACS patients with 2 year follow-up.

CLINICAL TRIAL REGISTRATION

NCT01373957.

RESULTS

A total of 600 ACS patients (71.1% male, mean age 60 years) were enrolled; 599 were included for analysis. Diagnosis comprised STEMI (n = 375, 62.6%), NSTEMI (n = 147, 24.5%), and unstable angina (UA) (n = 77, 12.9%). Percutaneous coronary intervention (PCI) was conducted in 64.3% of patients with STEMI (with or without thrombolysis), 36.7% with NSTEMI, and 58.4% with UA. There was undertreatment with dual antiplatelet therapy (DAPT) for STEMI, NSTEMI, and UA: 14.7%, 25.9% and 16.9% of patients, respectively, were not receiving DAPT during hospitalization, and 10.1%, 21.8% and 16.9% at discharge. Post-discharge, of the STEMI group, only 72.4% of patients who were managed by PCI and 39.8% of conservatively treated patients received DAPT at 12 months. The respective figures in the NSTEMI group were 77.3% and 26.4%. In the STEMI cohort the cumulative incidence of all-cause mortality was 3.2% at 1 year and 5.1% at 2 years of follow-up; in the NSTEMI cohort this was 2.7% and 4.8%, respectively. There were no deaths by 12 months and one death by 24 months (1.3%) in the UA population.

CONCLUSION

Despite evidence-based guidelines for the management of ACS, the real-world setting in Russia shows discrepancies in clinical practice, highlighting the need for improvements for the optimal management of high-risk patients with ACS.

Authors+Show Affiliations

a The Russian Cardiology Research and Production Complex , Moscow , Russian Federation.b City Clinical Hospital #15 , Moscow , Russian Federation.c AstraZeneca , Medical Department , Moscow , Russian Federation.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

28420281

Citation

Ruda, Mikhail Ya, et al. "Long-term Follow-up of Antithrombotic Management Patterns in Patients With Acute Coronary Syndrome in Russia: an Observational Study (EPICOR-RUS Study)." Current Medical Research and Opinion, vol. 33, no. 7, 2017, pp. 1269-1276.
Ruda MY, Averkov OV, Khomitskaya YV. Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in Russia: an observational study (EPICOR-RUS study). Curr Med Res Opin. 2017;33(7):1269-1276.
Ruda, M. Y., Averkov, O. V., & Khomitskaya, Y. V. (2017). Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in Russia: an observational study (EPICOR-RUS study). Current Medical Research and Opinion, 33(7), 1269-1276. https://doi.org/10.1080/03007995.2017.1313214
Ruda MY, Averkov OV, Khomitskaya YV. Long-term Follow-up of Antithrombotic Management Patterns in Patients With Acute Coronary Syndrome in Russia: an Observational Study (EPICOR-RUS Study). Curr Med Res Opin. 2017;33(7):1269-1276. PubMed PMID: 28420281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in Russia: an observational study (EPICOR-RUS study). AU - Ruda,Mikhail Ya, AU - Averkov,Oleg V, AU - Khomitskaya,Yunona V, Y1 - 2017/04/19/ PY - 2017/4/20/pubmed PY - 2018/1/5/medline PY - 2017/4/20/entrez KW - Acute coronary syndrome KW - antithrombotic agents KW - clinical outcomes KW - observational study KW - quality of life KW - real-world SP - 1269 EP - 1276 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 33 IS - 7 N2 - OBJECTIVE: This study sought to describe the short- and long-term (up to 2 years) antithrombotic management patterns in a real-life setting for patients hospitalized for an acute coronary syndrome (ACS) event, and to document clinical outcomes. RESEARCH DESIGN AND METHODS: EPICOR-RUS was a multicenter (34 centers), prospective, observational, longitudinal cohort study conducted across Russia on antithrombotic management in hospitalized (within 24 hours of symptom onset) ACS patients with 2 year follow-up. CLINICAL TRIAL REGISTRATION: NCT01373957. RESULTS: A total of 600 ACS patients (71.1% male, mean age 60 years) were enrolled; 599 were included for analysis. Diagnosis comprised STEMI (n = 375, 62.6%), NSTEMI (n = 147, 24.5%), and unstable angina (UA) (n = 77, 12.9%). Percutaneous coronary intervention (PCI) was conducted in 64.3% of patients with STEMI (with or without thrombolysis), 36.7% with NSTEMI, and 58.4% with UA. There was undertreatment with dual antiplatelet therapy (DAPT) for STEMI, NSTEMI, and UA: 14.7%, 25.9% and 16.9% of patients, respectively, were not receiving DAPT during hospitalization, and 10.1%, 21.8% and 16.9% at discharge. Post-discharge, of the STEMI group, only 72.4% of patients who were managed by PCI and 39.8% of conservatively treated patients received DAPT at 12 months. The respective figures in the NSTEMI group were 77.3% and 26.4%. In the STEMI cohort the cumulative incidence of all-cause mortality was 3.2% at 1 year and 5.1% at 2 years of follow-up; in the NSTEMI cohort this was 2.7% and 4.8%, respectively. There were no deaths by 12 months and one death by 24 months (1.3%) in the UA population. CONCLUSION: Despite evidence-based guidelines for the management of ACS, the real-world setting in Russia shows discrepancies in clinical practice, highlighting the need for improvements for the optimal management of high-risk patients with ACS. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/28420281/Long_term_follow_up_of_antithrombotic_management_patterns_in_patients_with_acute_coronary_syndrome_in_Russia:_an_observational_study__EPICOR_RUS_study__ L2 - http://www.tandfonline.com/doi/full/10.1080/03007995.2017.1313214 DB - PRIME DP - Unbound Medicine ER -