title: Differences in the use of guideline-recommended therapies among 14 European countries in patients with acute coronary syndromes undergoing PCI.
abstract: OBJECTIVE
  Despite common European Society of Cardiology recommendations, adherence to guideline therapy varies, both temporally and geographically. We sought to examine current differences in the use of guideline-recommended therapies among 14 European countries in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
  
  
  RESULTS
  Data were obtained from the Antiplatelet Therapy Observational Registry (APTOR), a non-interventional, prospective observational cohort study enrolling patients with ACS undergoing PCI. Medication data were captured through 1 year. The large majority of patients in the APTOR registry received statins at hospital discharge (89%) and remained on statins at 1 year (87%), a finding that was consistent across countries. Likewise, beta-blocker use was similar at discharge and 1 year (83 and 81%, respectively). There was large disparity in aspirin loading dose between countries, but the discharge maintenance dose was more consistent, with most receiving ≤ 100 mg (87%). While 95% of patients were discharged on dual antiplatelet therapy, 71% remained on both treatments by 1 year, with wide variation by country in 1-year use.
  
  
  CONCLUSIONS
  These data from the APTOR study provide key information on current European ACS patient care management from hospitalization through 1 year. Even with European Society of Cardiology (ESC) guidelines, variations in practice patterns exist among ACS patients treated with PCI between the 14 European countries studied, including the use of proven therapies, as well as appropriate duration and dosing of antiplatelet regimens. Efforts are needed to further explain why such variation exists and to continue to improve adherence to ESC guidelines to improve patient care.
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Stefan
authors.initials: S
authors.lastname: James
authors.forename: Guy
authors.initials: G
authors.lastname: Berkenboom
authors.forename: Attila
authors.initials: A
authors.lastname: Mohacsi
authors.forename: Andres
authors.initials: A
authors.lastname: Iñiguez
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Coufal
authors.forename: Magali
authors.initials: M
authors.lastname: Sartral
authors.forename: Marie-Ange
authors.initials: MA
authors.lastname: Paget
authors.forename: Kirsi
authors.initials: K
authors.lastname: Norrbacka
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrieres
authors.forename: Ameet
authors.initials: A
authors.lastname: Bakhai
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000628:therapy*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D017723:Drug Utilization Review; D005060:Europe; D005260:Female; D019983:Guideline Adherence; D054625:Healthcare Disparities / Q000592:standards*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality / Q000592:standards*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011446:Prospective Studies; D019984:Quality Indicators, Health Care / Q000592:standards; D012042:Registries; D015607:Stents / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors