Influence of updated guidelines on short- and long-term mortality in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS)

Vogel, Birgit; Hahne, Sarah; Kozanli, I.; Kalla, Karim; Járai, Rudolf; Freynhofer, Matthias K.; Smetana, Peter; Nürnberg, Michael; Geppert, Alexander; Unger, G.; Huber, Kurt

doi:10.1016/j.ijcard.2011.02.073

Cited by 13 publications

(5 citation statements)

References 26 publications

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“…26 Moreover, in a very recent national register study from Taiwan investigating 3131 acute coronary syndrome patients, 12% had unstable angina pectoris, 34% had NSTEMI, and STEMI was found in 53%. 17 In accordance with earlier studies 19,27,32 the NSTEMI and unstable angina pectoris patients in the present cohort study received less guideline-driven treatment than the STEMI patients.…”

Section: Proportions Of Unstable Angina Pectoris Nstemi and Stemisupporting

confidence: 88%

Diagnosis of Unstable Angina Pectoris Has Declined Markedly with the Advent of More Sensitive Troponin Assays

D’Souza

Sarkisian

Saaby

et al. 2015

The American Journal of Medicine

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Section: Proportions Of Unstable Angina Pectoris Nstemi and Stemisupporting

confidence: 88%

Diagnosis of Unstable Angina Pectoris Has Declined Markedly with the Advent of More Sensitive Troponin Assays

D’Souza

Sarkisian

Saaby

et al. 2015

The American Journal of Medicine

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“…22 Before that the majority of patients was either treated with a conservative approach or received delayed revascularization in accordance with a ‘cooling-off’ strategy. 23…”

Section: Discussionmentioning

confidence: 99%

“…22 Before that the majority of patients was either treated with a conservative approach or received delayed revascularization in accordance with a 'cooling-off' strategy. 23 Concerning the diagnosis of cardiovascular events women more often than men present with atypical symptoms and non-diagnostic electrocardiograms. [24][25][26] Besides age and comorbidities this might be another reason for the less invasive treatment approach in women.…”

Section: Discussionmentioning

confidence: 99%

Sex-related differences in baseline characteristics, management and outcome in patients with acute coronary syndrome without ST-segment elevation

Vogel

Farhan

Hahne

et al. 2015

European Heart Journal: Acute Cardiovascular Care

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“…The growing economic burden of patients admitted with NSTE-ACS is expected to exceed the costs of STEMI patients [23]. The application of updated guidelines improved the prognosis of patients hospitalized with NSTE-ACS, thank/inherent to the increased use of coronary revascularization [30]. However, the optimal timing of revascularization with NSTE-ACS is still debated due to a lack of evidence, especially the benefit of early revascularization [31].…”

Section: Application Of Evidence-based Medicinementioning

confidence: 99%

Emerging Concepts and Designing Effectiveness Research in the Process of Care of Patients Hospitalized with an Uncomplicated Acute Coronary Syndrome

Gencer

Girardin²,

Sigaud³

et al. 2013

J Clin Trials

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Background: Clinical researchers are major actors in translating evidence-based medicine into the care of patients. Acute Coronary Syndrome (ACS) is a good example for the implementation of complex intervention in the current context of growing economic pressure. According to the 2012 European Society of Cardiology guidelines, early discharge (approximately 72 hours of hospitalization) is reasonable in selected low-risk patients hospitalized with STEMI (ST-elevation myocardial infarction), if early rehabilitation is arranged. However, early discharge is not widely applied in clinical practice, and the potential barriers to shorten LOS have not been studied for patients hospitalized with an ACS. Method: We will prospectively enroll 200 patients hospitalized with an ACS at the Geneva University Hospital using a before (100 patients, 2012-2013) and after (100 patients, 2013-2014) prospective cohort design. We will implement a systematic intervention consisting of four steps: (1) identification of low-risk patients treated successfully with percutaneous intervention using the Zwolle index Score; (2) targeting promptly an early discharge date within 72 hours after admission; (3) definition of a standard process of care during the hospital stay and (4) referral to a cardiac rehabilitation program within 10 days. As primary outcome, we will assess the evolution of LOS using administrative data. As secondary outcomes, we will analyze the potential barriers to an early discharge, the indicators of quality of care and the cost benefits comparing both periods before and after the implementation of an early discharge strategy. We will also assess the safety with a phone call at 30-day. Summary: In the area of increase concerns on the long-term sustainability of the current health system, translational science focusing on clinical effectiveness is more than needed. The systematic application of evidencebased recommendation is a way to improve the efficiency of process of care, as well as the transition from inpatient to outpatient setting.

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Influence of updated guidelines on short- and long-term mortality in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS)

Cited by 13 publications

References 26 publications

Diagnosis of Unstable Angina Pectoris Has Declined Markedly with the Advent of More Sensitive Troponin Assays

Diagnosis of Unstable Angina Pectoris Has Declined Markedly with the Advent of More Sensitive Troponin Assays

Sex-related differences in baseline characteristics, management and outcome in patients with acute coronary syndrome without ST-segment elevation

Emerging Concepts and Designing Effectiveness Research in the Process of Care of Patients Hospitalized with an Uncomplicated Acute Coronary Syndrome

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