title: Observational study of adherence to European clinical practice guidelines for the management of acute coronary syndrome in revascularized versus non-revascularized patients - the CONNECT Study.
abstract: BACKGROUND
  The CONNECT study compared clinician adherence to guideline-recommended secondary prevention therapies prescribed at discharge for patients hospitalized for acute coronary syndrome (ACS) in those managed initially with percutaneous coronary intervention (PCI; revascularized) and those who did not undergo revascularization.
  
  
  METHODS
  Patients aged greater than or equal to 18 years, hospitalized for a documented ST-segment elevation or non-ST-segment elevation ACS, were enrolled consecutively over 1 month at 238 sites in France.
  
  
  RESULTS
  Compared with revascularized patients (n=870), non-revascularized patients (n=706) were significantly older, and a greater proportion were women, had high-blood pressure, type-2 diabetes or a history of atherothrombotic or cardiac disease, but a smaller proportion had a history of coronary angioplasty. On discharge, non-revascularized patients were prescribed beta-blockers, aspirin, statins, angiotensin-converting enzyme inhibitors or adenosine diphosphate receptor antagonists less frequently than revascularized patients. An adherence score greater than or equal to 80% (at least four of the five recommended agents prescribed at discharge) was found in 96.7% of revascularized patients and 74.4% of non-revascularized patients (P<0.001).
  
  
  CONCLUSIONS
  Despite a similar or even higher level of cardiovascular risk, non-revascularized ACS patients were prescribed guideline-recommended secondary prevention therapy less frequently than revascularized patients.
authors.affiliation: Groupe Hospitalier Pitié-Salpétrière, Institut de Cardiologie, 47-83, boulevard de l'Hôpital, 75651 Paris Cedex 13, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Sabouret
authors.forename: Philippe
authors.initials: P
authors.lastname: Asseman
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Dujardin
authors.forename: François
authors.initials: F
authors.lastname: Philippe
authors.forename: Marie-Annick
authors.initials: MA
authors.lastname: Herrmann
authors.forename: Gilles
authors.initials: G
authors.lastname: Montalescot
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D004363:Drug Utilization; D005260:Female; D005602:France; D019983:Guideline Adherence; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D055502:Secondary Prevention
chemical_list: D002317:Cardiovascular Agents