[How are patients with acute coronary syndromes treated in Norwegian hospitals?].
BACKGROUND
Despite recent advances in the understanding and treatment of the acute coronary syndromes, the extent to which this progress is applied in clinical practice in Norway is uncertain.


METHODS
We performed a nation-wide retrospective survey in 17 Norwegian hospitals to delineate the characteristics and treatment of these patients. During the last quarter of 2000, data on 913 consecutive patients who were discharged with a diagnosis of acute coronary syndrome were analysed.


RESULTS
The women (37%) were on average older (median 77 years) than the men (median 69 years), they more often had hypertension and diabetes mellitus. Men were more frequently treated with statins and had a history of smoking. A similar proportion of each gender had acute myocardial infarction (68%). Coronary angiography was performed in 338 (37%). Medical treatment was similar for both genders, but women were less frequently offered angiography (27%) than men (43%), p < 0.001). In multivariate analysis the gender difference was significant for the youngest patients. Patients treated at community hospitals where less likely to undergo angiography (26%) than patients treated at regional hospitals (57%), p < 0.001.


CONCLUSIONS
This survey reveals significant differences in the management of acute coronary syndrome patients even in a public health care system. Women and patients treated at community hospitals were to a lesser degree offered coronary angiography.
Melberg
Tor
T
Medisinsk avdeling, Stavanger Universitetssykehus, 4068 Stavanger. tmelberg@online.no
Thoresen
Magne
M
Hansen
John-Bjarne
JB
Westheim
Arne
A
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D009204:Myocardial Revascularization / Q000379:methods; D009664:Norway; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy