Global patterns of health care for acute coronary syndromes.
OBJECTIVE
Despite similar guidelines, remarkable global differences exist in the management of acute coronary syndromes. This review describes recent insights in global patterns of patient baseline characteristics, treatment strategies, medication use, and outcome in acute coronary syndromes.


RESULTS
Results from recent registries and randomized clinical trials suggest that the arrival of many novel medications and treatment options for acute coronary syndromes has led to interregional heterogeneity in the management and treatment of patients with acute coronary syndromes. These differences in health care and adherence to national and international guidelines appear to be influenced by geographical, social, cultural, and economic factors, resulting in regional variation in hospital characteristics, physician attitude, access to resources or advanced cardiovascular care, access to the literature, and the availability of drugs.


CONCLUSIONS
Significant differences in diagnosis and treatment of acute coronary syndrome patients can be observed globally, despite similar guidelines based on the same randomized clinical trials. Guidelines are not adapted promptly worldwide, influencing outcome and health care expenditure.
Sinnaeve
Peter R
PR
Department of Cardiology, University of Leuven, Leuven, Belgium.
Van de Werf
Frans J
FJ
D000208:Acute Disease; D000789:Angina, Unstable / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003695:Delivery of Health Care / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D038622:Internationality; D007902:Length of Stay; D009203:Myocardial Infarction / Q000628:therapy; D013577:Syndrome