title: Treatment patterns in acute coronary syndrome patients in the United Kingdom undergoing PCI.
abstract: OBJECTIVE
  To evaluate practice patterns in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), focusing on the United Kingdom (UK).
  
  
  RESULTS
  The Antiplatelet Therapy Observational Registry (APTOR) is a prospective observational study of consecutive ACS patients undergoing PCI (N=1525) from January-August 2007 in the UK, France, and Spain. In the UK, median time from hospital admission to PCI was one day post-admission (IQR 0,4) among STEMI patients and five days (IQR 2,9) among unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI) patients. Patients in the UK most frequently received a 300 mg aspirin loading dose (85%), 300 mg clopidogrel loading dose (70%), and 75 mg clopidogrel maintenance dose (99%). Loading dose was given on the day of hospitalisation to 80% of STEMI patients and 68% of UA/NSTEMI patients. Clopidogrel was discontinued by 12 months in 30% of UK patients. Length of hospitalisation was similar between the three countries.
  
  
  CONCLUSIONS
  Despite established consensus guidelines for ACS patient management, APTOR data show disparity in management practices for ACS patients undergoing PCI in the UK and two other European countries. These data can help provide focus for areas of ACS management requiring improvements to meet guideline therapy, including reducing time from hospitalisation to PCI and maintaining 12 months of dual antiplatelet therapy for all ACS patients undergoing stenting.
authors.affiliation: Barnet & Chase Farm NHS Trust, Barnet, United Kingdom. abakhai@tiscali.co.uk
authors.forename: Ameet
authors.initials: A
authors.lastname: Bakhai
authors.forename: Andres
authors.initials: A
authors.lastname: Iñiguez
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrieres
authors.forename: Claude
authors.initials: C
authors.lastname: Schmitt
authors.forename: Magali
authors.initials: M
authors.lastname: Sartral
authors.forename: Mark
authors.initials: M
authors.lastname: Belger
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D001241:Aspirin / Q000008:administration & dosage*; D000077144:Clopidogrel; D003328:Coronary Thrombosis / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D019233:Retreatment / Q000706:statistics & numerical data; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin