1. Differences in the use of guideline-recommended therapies among 14 European countries in patients with acute coronary syndromes undergoing PCI
- Author
-
Kirsi Norrbacka, Stefan James, Zdeněk Coufal, Uwe Zeymer, Attila Mohacsi, Guy Berkenboom, Jean Ferrières, Magali Sartral, Andrés Iñiguez, Ameet Bakhai, and Marie-Ange Paget
- Subjects
Male ,medicine.medical_specialty ,Acute coronary syndrome ,Time Factors ,Epidemiology ,medicine.medical_treatment ,Adrenergic beta-Antagonists ,Kaplan-Meier Estimate ,Drug Utilization Review ,Percutaneous Coronary Intervention ,Humans ,Medicine ,In patient ,Prospective Studies ,Registries ,Acute Coronary Syndrome ,Healthcare Disparities ,Practice Patterns, Physicians' ,Intensive care medicine ,Aged ,Quality Indicators, Health Care ,Patient discharge ,Secondary prevention ,business.industry ,Percutaneous coronary intervention ,Cardiovascular Agents ,Guideline ,Middle Aged ,Clopidogrel ,medicine.disease ,Drug Utilization ,Patient Discharge ,Europe ,Treatment Outcome ,Practice Guidelines as Topic ,Conventional PCI ,Drug Therapy, Combination ,Female ,Stents ,Guideline Adherence ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Despite common European Society of Cardiology recommendations, adherence to guideline therapy varies, both temporally and geographically. We sought to examine current differences in the use of guideline-recommended therapies among 14 European countries in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).Data were obtained from the Antiplatelet Therapy Observational Registry (APTOR), a non-interventional, prospective observational cohort study enrolling patients with ACS undergoing PCI. Medication data were captured through 1 year. The large majority of patients in the APTOR registry received statins at hospital discharge (89%) and remained on statins at 1 year (87%), a finding that was consistent across countries. Likewise, beta-blocker use was similar at discharge and 1 year (83 and 81%, respectively). There was large disparity in aspirin loading dose between countries, but the discharge maintenance dose was more consistent, with most receiving ≤ 100 mg (87%). While 95% of patients were discharged on dual antiplatelet therapy, 71% remained on both treatments by 1 year, with wide variation by country in 1-year use.These data from the APTOR study provide key information on current European ACS patient care management from hospitalization through 1 year. Even with European Society of Cardiology (ESC) guidelines, variations in practice patterns exist among ACS patients treated with PCI between the 14 European countries studied, including the use of proven therapies, as well as appropriate duration and dosing of antiplatelet regimens. Efforts are needed to further explain why such variation exists and to continue to improve adherence to ESC guidelines to improve patient care.
- Published
- 2012
- Full Text
- View/download PDF