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Two-year outcomes post-discharge in Asian patients with acute coronary syndrome: Findings from the EPICOR Asia study.
Int J Cardiol. 2020 09 15; 315:1-8.IJ

Abstract

AIMS

Approximately half of cases of cardiovascular disease (CVD) worldwide occur in Asia, with acute coronary syndrome (ACS) a leading cause of mortality. Long-term ACS-related outcomes data in Asia are limited. This analysis examined 2-year ACS-related outcomes in patients enrolled in the EPICOR Asia study, and the association between patient characteristics and management on outcomes.

METHODS

EPICOR Asia is a multinational, prospective, primary data collection study of real-world management of Asian patients with ACS. Overall, 12,922 eligible adults (hospitalized for ACS within 48 h of symptom onset and who survived to discharge) were enrolled from 219 centers in eight Asian countries. Patients were followed up post-discharge for 2 years and clinical outcomes recorded.

RESULTS

Patients were of mean age 60 years and 76% were male. Diagnoses were STEMI (51.2%), NSTEMI (19.9%), and UA (28.9%). During follow-up, 5.2% of patients died; NSTEMI patients had the highest risk profile. Mortality rate (adjusted HR [95% CI]) was similar in NSTEMI (0.97 [0.81-1.17]) and lower in UA (0.52 [0.33-0.82]) vs STEMI. Similar trends (adjusted) were seen for the composite endpoint of death, myocardial infarction, or ischemic stroke, and bleeding rates did not differ significantly. For all three diagnoses, patients who were medically managed had a markedly elevated risk of both death and the composite endpoint.

CONCLUSIONS

During 2-year follow-up, adjusted risks of mortality, the composite endpoint, and bleeding rates were similar in NSTEMI and STEMI patients. Outcomes risk was better for invasive management. Long-term management strategies in Asia need to be optimized.

Authors+Show Affiliations

Peking University First Hospital, Beijing, China. Electronic address: huoyong@263.net.cn.Queen Mary Hospital, Hong Kong, China.Sir Ganga Ram Hospital, New Delhi, India.Seoul National University Hospital, Seoul, Republic of Korea.Siriraj Hospital, Bangkok, Thailand.London School of Hygiene and Tropical Medicine, London, UK.Cho Ray Hospital, Ho Chi Minh City, Viet Nam.Imperial College, National Health Service (NHS) Trust, London, UK.National Heart Centre Singapore, Singapore.Peking University First Hospital, Beijing, China.The George Institute for Global Health, University of New South Wales, Sydney, Australia.Medical Evidence and Observational Research, Global Medical Affairs, AstraZeneca, Madrid, Spain.AstraZeneca, Osaka, Japan.Sarawak General Hospital, Kuching, Malaysia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32389764

Citation

Huo, Yong, et al. "Two-year Outcomes Post-discharge in Asian Patients With Acute Coronary Syndrome: Findings From the EPICOR Asia Study." International Journal of Cardiology, vol. 315, 2020, pp. 1-8.
Huo Y, Lee SW, Sawhney JPS, et al. Two-year outcomes post-discharge in Asian patients with acute coronary syndrome: Findings from the EPICOR Asia study. Int J Cardiol. 2020;315:1-8.
Huo, Y., Lee, S. W., Sawhney, J. P. S., Kim, H. S., Krittayaphong, R., Pocock, S. J., Nhan, V. T., Alonso-Garcia, Á., Chin, C. T., Jiang, J., Jan, S., Vega, A. M., Hayashi, N., & Ong, T. K. (2020). Two-year outcomes post-discharge in Asian patients with acute coronary syndrome: Findings from the EPICOR Asia study. International Journal of Cardiology, 315, 1-8. https://doi.org/10.1016/j.ijcard.2020.05.022
Huo Y, et al. Two-year Outcomes Post-discharge in Asian Patients With Acute Coronary Syndrome: Findings From the EPICOR Asia Study. Int J Cardiol. 2020 09 15;315:1-8. PubMed PMID: 32389764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two-year outcomes post-discharge in Asian patients with acute coronary syndrome: Findings from the EPICOR Asia study. AU - Huo,Yong, AU - Lee,Stephen W-L, AU - Sawhney,Jitendra P S, AU - Kim,Hyo-Soo, AU - Krittayaphong,Rungroj, AU - Pocock,Stuart J, AU - Nhan,Vo T, AU - Alonso-Garcia,Ángeles, AU - Chin,Chee Tang, AU - Jiang,Jie, AU - Jan,Stephen, AU - Vega,Ana M, AU - Hayashi,Nobuya, AU - Ong,Tiong Kiam, Y1 - 2020/05/07/ PY - 2019/08/23/received PY - 2020/02/28/revised PY - 2020/05/06/accepted PY - 2020/5/12/pubmed PY - 2020/5/12/medline PY - 2020/5/12/entrez KW - Acute coronary care KW - Acute coronary syndrome KW - Antithrombotic management patterns KW - Asia KW - Observational KW - Post-discharge mortality SP - 1 EP - 8 JF - International journal of cardiology JO - Int J Cardiol VL - 315 N2 - AIMS: Approximately half of cases of cardiovascular disease (CVD) worldwide occur in Asia, with acute coronary syndrome (ACS) a leading cause of mortality. Long-term ACS-related outcomes data in Asia are limited. This analysis examined 2-year ACS-related outcomes in patients enrolled in the EPICOR Asia study, and the association between patient characteristics and management on outcomes. METHODS: EPICOR Asia is a multinational, prospective, primary data collection study of real-world management of Asian patients with ACS. Overall, 12,922 eligible adults (hospitalized for ACS within 48 h of symptom onset and who survived to discharge) were enrolled from 219 centers in eight Asian countries. Patients were followed up post-discharge for 2 years and clinical outcomes recorded. RESULTS: Patients were of mean age 60 years and 76% were male. Diagnoses were STEMI (51.2%), NSTEMI (19.9%), and UA (28.9%). During follow-up, 5.2% of patients died; NSTEMI patients had the highest risk profile. Mortality rate (adjusted HR [95% CI]) was similar in NSTEMI (0.97 [0.81-1.17]) and lower in UA (0.52 [0.33-0.82]) vs STEMI. Similar trends (adjusted) were seen for the composite endpoint of death, myocardial infarction, or ischemic stroke, and bleeding rates did not differ significantly. For all three diagnoses, patients who were medically managed had a markedly elevated risk of both death and the composite endpoint. CONCLUSIONS: During 2-year follow-up, adjusted risks of mortality, the composite endpoint, and bleeding rates were similar in NSTEMI and STEMI patients. Outcomes risk was better for invasive management. Long-term management strategies in Asia need to be optimized. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/32389764/Two_year_outcomes_post_discharge_in_Asian_patients_with_acute_coronary_syndrome:_Findings_from_the_EPICOR_Asia_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(19)34212-3 DB - PRIME DP - Unbound Medicine ER -
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