title: MASCARA (Manejo del Síndrome Coronario Agudo. Registro Actualizado) study. General findings.
abstract: OBJECTIVE
  To investigate the clinical characteristics and treatment of acute coronary syndromes (ACS), and to determine the effects of an early invasive strategy (EIS) in non-ST-elevation ACS (NSTEACS) and of primary percutaneous coronary intervention (PCI) in ST-elevation ACS (STEACS).
  
  
  METHODS
  Data were collected prospectively for 9 months during 2004-2005 from 50 hospitals, which were randomly selected according to the level of care provided. In addition, follow-up data on mortality and readmission for ACS were collected for 6 months. The adjusted effects of different reperfusion strategies were analyzed.
  
  
  RESULTS
  After checking data quality, the analysis included data from 32 hospitals, which covered 7923 coronary events (4431 [56%] STEACS, 3034 [38%] NSTEACS and 458 [6%] unclassified ACS) in 7251 patients. Compared with previous studies, the use of primary PCI in STEACS had increased markedly (from 10.7% to 36.8% of patients undergoing reperfusion), as had the use of EIS in NSTEACS (from 11.1% to 19.6%). Overall in-hospital mortality was 5.7% (95% confidence interval [CI], 5.1%-6.2%); for STEACS it was 7.6% (95% CI, 6.7%-8.7%), for NSTEACS 3.9% (95% CI, 3.3%-4.6%), and for unclassified ACS 8.8% (95% CI, 6.2%-12.2%). In the population as a whole, there was no association between prognosis (i.e., 6-month mortality) and EIS in NSTEACS (hazard ratio [HR]=0.94; 95% CI, 0.66-1.3) or between prognosis and primary PCI in STEACS (HR=1; 95% CI, 0.7-1.5). Findings for mortality and rehospitalization for ACS at 6 months were similar.
  
  
  CONCLUSIONS
  Data for 2004-2005 demonstrated a marked increase in the use of invasive procedures. However, the procedures employed were poorly matched to the patients' baseline risk.
authors.affiliation: Unidad de Epidemiología, Servicio de Cardiología, Hospital Vall d'Hebron, CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ferreira-González
authors.forename: Gaietà
authors.initials: G
authors.lastname: Permanyer-Miralda
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.forename: Magda
authors.initials: M
authors.lastname: Heras
authors.forename: José
authors.initials: J
authors.lastname: Cuñat
authors.forename: Emilia
authors.initials: E
authors.lastname: Civeira
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Rodríguez
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Sánchez
authors.forename: Héctor
authors.initials: H
authors.lastname: Bueno
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000628:therapy*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015425:Myocardial Reperfusion; D011446:Prospective Studies; D012042:Registries; D013030:Spain