[Register of acute coronary syndromes in Russia: treatment and in hospital outcomes in non-ST elevation acute coronary syndrome].

Kardiologiia

Research Institute for Physicochemical Medicine, Center of Atherosclerosis, ul. Malaya Pirogovskaya 1a, 119828 Moscow, Russia.

Published: July 2004

Data from about 50 consecutive patients with acute coronary syndromes aged > or =18 years admitted to 59 hospitals in different Russian cities were collected between November 2000 and July 2001. In addition to presumably ischemic symptoms within previous 24 hours they were to have ischemic ECG changes, documented coronary heart disease or positive markers of myocardial necrosis. Of 2806 patients included into registry 1394 (49.7%) had non-ST elevation acute coronary syndrome. Markers of myocardial necrosis (mainly CK activity) were evaluated in 59.5% of them. Frequency of interventions known to improve outcome was rather low: aspirin in acute phase was used in 73% (contraindications were reported just in 6%), thyenopyridines - in few cases, unfractionated heparin intravenously only with APTT control - in 11.8%, low-molecular weight heparins - in 7.4% of patients. Beta-blockers were prescribed in 55.6% of cases (with fist dose intravenously in 2.9%). Lipid lowering drugs were recommended on discharge to 15% of patients (to 20% with known hypercholesterolemia). Coronary angiography and revascularization procedures were performed in 25 (1.8%) and 11 (0.8%) patients, respectively. However hospital mortality appeared to be relatively low (3.8%). Meanwhile rates of (re)infactions and angina recurrences during hospitalization were high - 16.5 and 25.1% of cases, respectively.

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