[Registry of Acute Coronary Syndromes RECORD 3. Characteristics of Patients and Treatment During Initial Hospitalization]
Acute Coronary Syndrome (ACS) Registries RECORD 1 2 (2007 2001) gave valuable information on management of ACS patients in Russia. RECORD 3 was carried out in March April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. MATERIAL AND METHODS RECORD 3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive" during 1 month. RESULTS Number of included pts was 2370 (39% women, mean age 64.6 years) 72% were admitted to invasive hospitals, 37% had ST elevation ACS (STEACS) Median "onset of symptoms first medical contact" time was 3.4 (1.0 16.8) hours, "first medical contact hospital admission" time 1.5 (1.0 3.1) hours. Cardiac troponin was determined in 76% of pts. Coronary angiography was carried out in 70 and 46% of pts with STE and non STE ACS, respectively. (16% of all patients hospitalized in "noninvasive" cetnters were transferred for angiography to invasive ones) Primary percutaneous coronary intervention (PCI) was performed in 39% of patients with STEACS (in 65% of them with "door to pPCI" time less or equal 90 min) Thrombolytic therapy (TLT) was administered to 32% of pts (in half of them prehospitally) Overall reperfusion therapy received 68% of pts. Among non STEACS pts rate of PCI was 20% (1/3 of procedures within 2, 1/3 >2 24hours) Inhospital antiplatelet therapy (APT) included aspirin (88% clopidogrel (71% ticagrelor (14% 86% of pts received dual APT. Other medications were: unfractionated heparin (UFH, 47% [81% subcutaneously] enoxaparin (13% fondaparinux (10% angiotensin converting enzyme inhibitors/sartans (81% adrenoblockers (84% statins (87% Mortality during hospitalization (median 10 days) was 10% in STE, and 5% in non STE ACS. CONCLUSION Inhospital management of RECORD 3 population was characterized by relatively low rates of pPCI, reperfusion therapy in STEACS, urgent PCI in non STEACS. Preponderance of UFG including its subcutaneous use is of note. Use of other standard therapies appears satisfactory.
Kardiologiia