Document Detail


Treatment patterns in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
MedLine Citation:
PMID:  20673167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Antiplatelet Therapy Observational Registry (APTOR) is a prospective observational study of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) in a 'real world' clinical setting. Here the authors report on the management of ACS patients in three European countries during the hospital phase and through 12-months' follow-up, including use of antiplatelet agents, co-medications and stents, as well as clinical outcomes at 12 months.
METHODS: ACS patients undergoing PCI (N = 1525) from January to August 2007 were planned to be consecutively recruited in France, Spain and the UK.
RESULTS: Index diagnosis was unstable angina/non-ST-segment elevation myocardial infarction (MI) in 62% and ST-segment elevation MI in 38%. Prior to the index ACS event, 17% were prescribed both aspirin and clopidogrel. While in-hospital clopidogrel and aspirin use was similar across countries, considerable variation was observed between countries at 12 months (clopidogrel 66-75%; aspirin 86-95%). The UK most frequently used a 300-mg clopidogrel loading dose (70%) compared with France (53%) and Spain (56%), while >300 mg was used in 21%, 34% and 16% patients, respectively. Bare metal stents only were used in 42% of subjects, drug-eluting stents (DES) only in 40%, and both in 10%, with the highest rates of DES use in Spain (70%) followed by the UK (47%) and France (31%). The composite endpoint of cardiovascular (CV) death, MI or stroke occurred in 4.7% of patients by 12 months.
CONCLUSIONS: APTOR shows marked variation in ACS management between countries in antiplatelet therapy, co-medications and stent use. Due to the observational design of the registry, statistical testing was not applied and data should be seen as hypothesis generating. These data provide a useful benchmark for comparison with current guidelines.
Authors:
Jean Ferrieres; Ameet Bakhai; Andres Iñiguez; Claude Schmitt; Magali Sartral; Mark Belger; Uwe Zeymer;
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Current medical research and opinion     Volume:  26     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-16     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  2193-202     Citation Subset:  IM    
Affiliation:
Toulouse Rangueil University Hospital, Toulouse, France.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / epidemiology,  therapy*
Aged
Drug-Eluting Stents / statistics & numerical data
Endovascular Procedures / methods*,  utilization
Female
France
Great Britain
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Professional Practice
Registries
Spain
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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