[Coverage of pointed acute coronary syndromes in the general hospital centers].
This study presents data on the management of acute coronary syndromes collected in a national registry organized by the french Collège national des cardiologues des hôpitaux généraux in September 2000. In all 86 institutions participated and data from 607 patients (mean age: 67 years; 413 men) were analysed. The final diagnosis was unstable angina in 38%, non-Q wave myocardial infarction in 21% and Q-wave myocardial infarction in 40.5%. Median time to admission was 4 h. At symptom onset, patients called their general practitioners in 46% of cases, emergency ambulatory units in 31% of cases and arrived to the hospital on their own in 23% of cases. Observance of the European Society of Cardiology guidelines was good for patients without ST segment elevation. In patients with ST segment elevation, 9% had pre-hospital thrombolysis, 28% hospital thrombolysis, and 27% had angioplasty within 48 h of admission, including 9% with rescue angioplasty. Overall, 57% of patients with ST segment elevation received reperfusion therapy. In hospital mortality was 6% for the whole cohort, and 11% for patients with acute myocardial infarctions. By multivariate analysis, predictors of in-hospital mortality were age, type of acute coronary syndrome, absence of beta-blocker therapy, and absence of coronary angiography.
Hanssen
M
M
Service de cardiologie interventionnelle, centre hospitalier, 64, avenue du Pr. Leriche, 67504 Haguenau, France. michel.hanssen@ch-haguenau.fr
Monassier
J P
JP
Dujardin
J J
JJ
Hoden
S
S
Pedrazzini
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000401:mortality / Q000628:therapy*; D016507:Cardiology Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006769:Hospitals, General / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors