J 2019

Incidence, treatment strategies and outcomes of acute coronary syndrome with and without ongoing myocardial ischaemia: results from the CZECH-3 registry

TOUSEK, Petr, Klara STASKOVA, Anna MALA, Martin SLUKA, Alexandra VODZINSKA et. al.

Základní údaje

Originální název

Incidence, treatment strategies and outcomes of acute coronary syndrome with and without ongoing myocardial ischaemia: results from the CZECH-3 registry

Autoři

TOUSEK, Petr (203 Česká republika, garant), Klara STASKOVA (203 Česká republika), Anna MALA (203 Česká republika), Martin SLUKA (203 Česká republika), Alexandra VODZINSKA (203 Česká republika), Radek JANCAR (203 Česká republika), Denisa KREJČÍ (203 Česká republika, domácí), Jiří JARKOVSKÝ (203 Česká republika, domácí) a Petr WIDIMSKY (203 Česká republika)

Vydání

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, LONDON, SAGE PUBLICATIONS LTD, 2019, 2048-8726

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.813

Kód RIV

RIV/00216224:14110/19:00111955

Organizační jednotka

Lékařská fakulta

DOI

UT WoS

000501037700002

Klíčová slova anglicky

Acute coronary syndromes; ongoing myocardial ischaemia; treatment strategy; outcome

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 3. 1. 2020 12:25, Mgr. Tereza Miškechová

Anotace

V originále

Background: Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. Aim: To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. Methods: The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015. Acute coronary syndrome with ongoing myocardial ischaemia was defined by the presence of persistent/recurrent chest pain/dyspnoea and at least one of the following: persistent ST-segment elevation or depression, bundle branch block, haemodynamic or electric instability due to suspected ischaemia. Major adverse cardiac events (death, reinfarction, stroke, unexpected revascularisation, stent thrombosis) and severe bleeding according to Bleeding Academic Research Consortium criteria were evaluated at 30 days. Results: Acute coronary syndrome was ruled out during the hospital stay in 434 (24.7%) patients. Out of 1280 patients with confirmed acute coronary syndrome, 732 (57%) had clinical signs of ongoing myocardial ischaemia at first medical contact. Coronary angiography was performed in 94.7% of patients with confirmed acute coronary syndrome with ongoing myocardial ischaemia and 89% of patients with confirmed acute coronary syndrome without ongoing myocardial ischaemia (P<0.001). The major adverse cardiac event rate was 9.8% for patients with confirmed acute coronary syndrome with ongoing myocardial ischaemia and 5.5% for patients without ongoing myocardial ischaemia (P=0.005), the 30-day severe bleeding rate was 1.6% and 1.5% (P=1.0). Patients with ongoing myocardial ischaemia admitted to regional hospitals had higher major adverse cardiac event rates compared with patients admitted directly to cardiocentres with percutaneous coronary intervention capability (13.3% vs. 8.2%, P=0.034). Conclusions: Ongoing myocardial ischaemia was present in more than half of patients hospitalised with acute coronary syndrome. These very high-risk patients may benefit from direct admission to percutaneous coronary intervention-capable centres.