title: Impact of availability and use of coronary interventions on the prescription of aspirin and lipid lowering treatment after acute coronary syndromes.
abstract: BACKGROUND
  It has been suggested that patients undergoing acute intervention for coronary syndromes may not receive adequate secondary prevention.
  
  
  OBJECTIVE
  To analyse the impact of availability and use of coronary interventions on the prescription of secondary prevention after acute coronary syndromes.
  
  
  METHODS
  Analysis of a prospective multicentre register of patients admitted to hospital for acute coronary syndromes.
  
  
  METHODS
  A 1999 pan-European survey in 390 hospitals.
  
  
  METHODS
  3092 patients admitted to hospital with acute coronary syndromes (including 777 for ST elevation myocardial infarction within 12 hours of onset).
  
  
  METHODS
  Rates of prescription of aspirin and lipid lowering agents.
  
  
  RESULTS
  Performance of coronary angiography and percutaneous coronary interventions (PCI) during the hospital stay were independent predictors of prescription of aspirin at discharge (odds ratio (OR) 1.29 and 1.89, p = 0.053 and p < 0.0001, respectively). Lipid lowering agents were prescribed more often on discharge in patients admitted to hospitals with catheterisation laboratories than without (for infarction with ST elevation, 45% v 40% (NS); for other acute coronary syndromes, 46% v 36%; p < 0.05). Prescription rates were higher among patients undergoing coronary angiography or PCI than in those treated conservatively (for infarction with ST elevation, 49%, 53%, and 39%, p < 0.05; for other acute coronary syndromes, 50%, 54%, and 34%, p < 0.05). Logistic regression analysis showed that PCI was an independent predictor of prescription of lipid lowering agents at discharge (OR 1.48, p < 0.0002).
  
  
  CONCLUSIONS
  Contrary to expectations, invasive procedures for acute coronary syndromes are associated with higher rates of prescription of pharmacological secondary prevention.
authors.affiliation: Groupe Hospitalier Bichat - Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France. gabriel.steg@bch.ap-hop-paris.fr
authors.forename: P G
authors.initials: PG
authors.lastname: Steg
authors.forename: B
authors.initials: B
authors.lastname: Iung
authors.forename: L J
authors.initials: LJ
authors.lastname: Feldman
authors.forename: D
authors.initials: D
authors.lastname: Cokkinos
authors.forename: J
authors.initials: J
authors.lastname: Deckers
authors.forename: K A A
authors.initials: KA
authors.lastname: Fox
authors.forename: U
authors.initials: U
authors.lastname: Keil
authors.forename: A P
authors.initials: AP
authors.lastname: Maggioni
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use*; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000517:prevention & control*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D012042:Registries; D012044:Regression Analysis
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D005343:Fibrinolytic Agents; D000960:Hypolipidemic Agents; D001241:Aspirin