Register of Acute Coronary Syndromes in Russia: Management and Inhospital Outcomes in ST Elevation Acute Coronary Syndrome

摘要

Data of about 50 consecutive patients with acute coronary syndromes aged at least 18 years admitted to 59 hospitals in different Russian cities were collected from November 2000 to July 2001. In 1412 patients included into registry presumably ischemic symptoms within previous 24 hours were associated with ST-segment elevation or left bundle branch block on ECG. Demographics, history, characteristics of acute coronary syndrome, management and outcomes during hospitalization as well as diagnoses at presentation and discharge were analyzed. Markers of myocardial necrosis were measured in 61% of patients. Rates of interventions that may improve outcome appeared to be low. In acute phase aspirin was used in 79% (contraindications were reported in 6.2%). Within 12 hours of symptoms onset thrombolysis was performed in 12.9%, coronary angioplasty in 1.2%. In patients hospitalized within 12 hours of symptoms onset these rates were 21.3 and 1.9%, respectively. Beta-blockers were prescribed no more than in 60% of cases (fist dose intravenously in 4.3%). Lipid lowering drugs were recommended at discharge to 12.3% of patients (to 21.1% of those with known hypercholesterolemia). ACE inhibitors during hospitalization were used in 68.1% of patients. After acute phase of the disease coronary angioplasty was performed in 5 patients, CABG in 1. However hospital mortality appeared to be not high (8.5% in general, 10.1% in patients with overt acute myocardial infarction at presentation). Reinfaction rate in this registry was impossible to assess, angina recurrences were registered in every fifth patient.