title: The second Euro Heart Survey on acute coronary syndromes: Characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004.
abstract: OBJECTIVE
  Our study aimed to examine the management of acute coronary syndromes (ACS) in Europe and the Mediterranean basin, and to compare adherence to guidelines with that reported in the first Euro Heart Survey on ACS (EHS-ACS-I), 4 years earlier.
  
  
  RESULTS
  In a prospective survey conducted in 2004 (EHS-ACS-II), data describing the characteristics, treatment, and outcome of 6385 patients diagnosed with ACS in 190 medical centres in 32 countries were collected. ACS with ST-elevation was the initial diagnosis in 47% of patients, no ST-elevation in 48%, and undetermined electrocardiographic pattern in 5% of patients. Comparison of data collected in 2000 and 2004 showed similar baseline characteristics, but greater use of recommended medications and coronary interventions in EHS-ACS-II. Among patients with ST-elevation, the use of primary reperfusion increased slightly (from 56 to 64%), with a significant shift from fibrinolytic therapy to primary percutaneous coronary intervention (PPCI). The use of PPCI rose from 37 to 59% among those undergoing primary reperfusion therapy. Analysis of data in 34 centres that participated in both surveys showed even greater improvement with respect to the use of recommended medical therapy, interventions, and outcome.
  
  
  CONCLUSIONS
  Data from EHS-ACS-II suggest an increase in adherence to guidelines for treatment of ACS in comparison with EHS-ACS-I.
authors.affiliation: Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Lori
authors.initials: L
authors.lastname: Mandelzweig
authors.forename: Alex
authors.initials: A
authors.lastname: Battler
authors.forename: Valentina
authors.initials: V
authors.lastname: Boyko
authors.forename: Hector
authors.initials: H
authors.lastname: Bueno
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
authors.forename: Anselm
authors.initials: A
authors.lastname: Gitt
authors.forename: David
authors.initials: D
authors.lastname: Hasdai
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Hasin
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.forename: Frans
authors.initials: F
authors.lastname: Van de Werf
authors.forename: Lars
authors.initials: L
authors.lastname: Wallentin
authors.forename: Shlomo
authors.initials: S
authors.lastname: Behar
mesh_terms: D000208:Acute Disease; D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology* / Q000628:therapy; D005060:Europe; D005260:Female; D019983:Guideline Adherence; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012042:Registries