First national survey on management strategies in non ST-elevation acute ischaemic syndromes in Argentina. Results of the STRATEG-SIA study.
OBJECTIVE
To assess the management strategies applied in non-ST elevation acute ischaemic syndromes in Argentina, the factors influencing the choice of treatment, and their relationship to short- and long-term (1 year) patient outcomes.


RESULTS
We conducted a 1 month, prospective, population-based survey in 77 hospitals (all over the country). We recruited 492 patients (age 63.9+/-11.7 years, male sex 68.3%, and 59.8% acute ischaemic ECG changes). Subjects were stratified according to the AHCPR classification as: high risk 62.2%, intermediate 25.0% and low 12.8%. At 1 year, the rate of death or myocardial infarction according to risk category and invasive procedures employed were: high risk (angioplasty 5.4% vs coronary artery bypass grafting 12.1% vs medical treatment 17.2%; P=0.001), intermediate risk (angioplasty 5.7% vs coronary artery bypass grafting 12.5% vs medical treatment 4.7%, P=ns), and low risk (angioplasty 10.0% vs coronary artery bypass grafting 15.2% vs medical treatment 1.9%; P<0.001). In the overall population, the 1 year event rate was not significantly different between the invasive and medical treatment groups (11.5% vs 7.2%, P=0.09).


CONCLUSIONS
A routine, unselected invasive approach in non-ST elevation acute ischaemic syndromes in Argentina is associated with no apparent improvement of patients' outcome.
Ferreirós
E R
ER
Area de Investigación, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
Kevorkian
R
R
Fuselli
J J
JJ
Guetta
J
J
Boissonnet
C P
CP
di Toro
D
D
Cragnolino
R
R
Masoli
O
O
Cagide
A
A
Krauss
J
J
D000368:Aged; D000704:Analysis of Variance; D000789:Angina, Unstable / Q000401:mortality / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001118:Argentina / Q000453:epidemiology; D001026:Coronary Artery Bypass / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012044:Regression Analysis; D013577:Syndrome; D016896:Treatment Outcome