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.

Basic information

Original name

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

Authors

TOUSEK, Petr (203 Czech Republic, guarantor), Klara STASKOVA (203 Czech Republic), Anna MALA (203 Czech Republic), Martin SLUKA (203 Czech Republic), Alexandra VODZINSKA (203 Czech Republic), Radek JANCAR (203 Czech Republic), Denisa KREJČÍ (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution) and Petr WIDIMSKY (203 Czech Republic)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.813

RIV identification code

RIV/00216224:14110/19:00111955

Organization unit

Faculty of Medicine

DOI

UT WoS

000501037700002

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 3/1/2020 12:25, Mgr. Tereza Miškechová

Abstract

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.