Epidemiologic study of use of resources in patients with unstable angina: the EARISA registry. On behalf on the EARISA Investigators (Epidemiologia dell'Assorbimento di Risorse nell'Ischemia, Scompenso e Angina).
OBJECTIVE
The EARISA Registry was designed to describe diagnostic and therapeutic resources used in Italian cardiology centers for patients with the epidemiologically most relevant cardiac diseases. This article focuses on patients with unstable angina; characteristics associated with invasive procedures were specifically analyzed.


RESULTS
Information was collected over a 2-week period on 1420 patients with unstable angina discharged from 308 cardiology centers. The mean length of stay was 9 +/- 6 days; 51% of patients were admitted to a coronary care unit (mean length of stay, 4 +/- 3 days). Noninvasive procedures included echocardiography (64%), Holter monitoring (25%), exercise stress testing (24%), and echocardiographic stress testing or nuclear imaging (7%). Invasive procedures were coronary angiography (39%) and percutaneous transluminal coronary angioplasty or coronary artery bypass grafting (13%). Unstable angina had a greater impact on invasive procedures than acute myocardial infarction. Variables independently associated with a higher rate of coronary angiographic procedures were younger age, higher technologic level of the hospital, and need for intravenous therapy.


CONCLUSIONS
In Italy, approximately half the patients with unstable angina are admitted to hospitals without catheterization laboratories or cardiac surgery facilities. This fact supports the concept that treatments that can be administered in all types of hospitals are more likely to affect the outcome of patients with unstable angina. Overall, the rates of coronary angiography and revascularization procedures appeared low, and the setting where cardiologists practice, rather than patient characteristics, is the major determinant of the care given to patients with unstable angina.
ANMCO Research Center, Florence.
A P
AP
Maggioni
C
C
Schweiger
L
L
Tavazzi
T
T
Langiano
D
D
Lucci
C
C
Ramponi
F
F
Repetto
C
C
De Vita
D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003325:Coronary Care Units / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data