Abstract
The objective of this study was to determine the management and outcome of fewer selected
patients with an acute coronary syndrome during hospitalization and up to 1 year after
discharge. The Canadian Acute Coronary Syndromes Registry was a prospective observational
study of patients admitted with suspected acute coronary syndromes. Data on demographic
and clinical characteristics, in-hospital treatment, and outcomes were recorded. At
1 year, vital status, medication use, recurrent cardiac events, and procedures were
determined by telephone contact. Of the 5,312 patients enrolled, 4,627 had a final
diagnosis of acute coronary syndrome, with Q-wave myocardial infarction in 27.7%,
non–Q-wave myocardial infarction in 33.2%, and unstable angina pectoris in 39.1%.
During hospitalization, coronary angiography and revascularization were performed
in 39.6% and 20.3% of patients, respectively. The in-hospital mortality rate was 2.4%
overall. At discharge, 87.8%, 76.4%, 56.0%, and 54.8% of patients were prescribed
aspirin, β blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering
agents, respectively. Unadjusted 1-year mortality rates for hospital survivors were
6.5%, 10%, and 5.4% for those with Q-wave myocardial infarction, non–Q-wave myocardial
infarction, and unstable angina pectoris groups, respectively (p <0.0001). This difference
in mortality rate remained significant after adjusting for other prognosticators,
whereas the use of coronary angiography and revascularization after discharge was
similar across patients. At 1 year, fewer patients were maintained on aspirin and
β blockers, whereas the use of lipid-lowering therapy increased (all p <0.0001). Despite
similar rates of coronary angiography and revascularization after discharge, patients
with non–Q-wave myocardial infarction had worse outcomes at 1 year. Moreover, there
was a significant opportunity to enhance the discharge and long-term use of evidence-based
secondary prevention therapies.
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Article info
Publication history
Accepted:
March 19,
2004
Received in revised form:
March 19,
2004
Received:
January 30,
2004
Footnotes
☆This research was sponsored by the Canadian Heart Research Centre Toronto, Ontario, Canada, and Key Pharmaceuticals, Division of Schering Canada Inc., Pointe Claire, Quebec, Canada.
Identification
Copyright
© 2004 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
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- CorrectionAmerican Journal of CardiologyVol. 95Issue 3
- PreviewIn the article titled, “One-Year Outcome of Patients After Acute Coronary Syndromes (from the Canadian Acute coronary Syndromes Registry)” by Yan et al in the July 1, 2004, issue of the AJC, there is an error on page 25, in the Abstract section. The corrected sentence should read: “The objective of this study was to determine the management and outcome of less selected patients with an acute coronary syndrome during hospitalization and up to 1 year after discharge.”
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