| Demographics, treatment and outcome of acute coronary syndromes: 17 years of experience in a specialized cardiac centre. | |
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MedLine Citation:
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PMID: 16485046 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Epidemiological information on patients with acute coronary syndromes managed in specialized cardiac centres is limited. OBJECTIVE: To report the evolution of demographics, treatment and outcome of patients admitted to a tertiary coronary care unit (CCU) over a 17-year period. METHODS: A prospective database of 18,719 patients admitted from April 1986 to March 2003 in a 21-bed CCU was analyzed. RESULTS: From 1986 to 2003, the number of admissions increased from 937 to 1577 per year, while the length of stay declined from 7.5 to 3.5 days. The mean age increased from 58.4 to 63.4 years, and the proportion of men remained stable at approximately 70%. The use of coronary angiograms increased from 49.8% to 81.1% in all patients, while fibrinolysis dropped to 0.4%. In-hospital mortality decreased from 9% to 1.5%. The percentage of overall instrumentation (arterial line, central venous catheter, temporary pacemaker, Swan-Ganz catheter and intra-aortic balloon pump) decreased from 38% to 8.1%. From 1995 to 2003, the proportion of stenting during percutaneous transluminal coronary angioplasty increased dramatically from 0% to 86%. In the past five years, surgical revascularization has remained stable at approximately 20% of all admissions. The proportion of patients discharged with a noncoronary chest pain diagnosis has remained constant at approximately 4%. INTERPRETATION: There has been a tremendous increase in efficiency, with an approximate doubling of the admissions turnover rate in a tertiary CCU. Patients with acute coronary syndromes are stratified faster and treated more invasively. Therapeutic advances are reflected by an almost linear 0.5% per year decrease in in-hospital mortality. |
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Authors:
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Jean-Pierre S Awaida; Jocelyn Dupuis; Pierre Théroux; Guy Pelletier; Michel Joyal; Pierre De Guise; Serge Doucet; Luc Bilodeau; Bernard Thibault; Jean-Francois Tanguay; Richard Gallo; Jean Grégoire; Philippe L L'Allier; Laurent Macle; Anil Nigam |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Canadian journal of cardiology Volume: 22 ISSN: 0828-282X ISO Abbreviation: Can J Cardiol Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-02-17 Completed Date: 2006-03-28 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: Canada |
Other Details:
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Languages: eng Pagination: 121-4 Citation Subset: IM |
Affiliation:
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Research Centre, Montreal Heart Institute, and Department of Medicine, University of Montreal, Quebec, Canada. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Distribution Angioplasty, Transluminal, Percutaneous Coronary / statistics & numerical data Cerebral Revascularization / statistics & numerical data Coronary Care Units / statistics & numerical data* Coronary Disease / epidemiology*, therapy* Demography Female Humans Intra-Aortic Balloon Pumping / statistics & numerical data Male Middle Aged Outcome Assessment (Health Care) Prospective Studies Quebec / epidemiology Retrospective Studies Sex Distribution Stents / statistics & numerical data Treatment Outcome |
| Comments/Corrections | |
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