title: Current discharge management of acute coronary syndromes: data from the Rijnmond Collective Cardiology Research (CCR) study.
abstract: BACKGROUND
  Medical discharge management of acute coronary syndromes (ACS) remains suboptimal outside randomised trials and constitutes an essential quality benchmark for ACS. We sought to evaluate the rates of key guideline-recommended pharmacological agents after ACS and characteristics associated with optimal treatment at discharge.
  
  
  METHODS
  The Rijnmond Collective Cardiology Research (CCR) registry is an ongoing prospective, observational study in the Netherlands that aims to enrol 4000 patients with ACS. We examined discharge and 1-month follow-up medication use among the first 1000 patients enrolled in the CCR registry. Logistic regression was performed to identify patient and hospital characteristics associated with collective guideline-recommended pharmacotherapy at hospital discharge.
  
  
  RESULTS
  At discharge, 94 % of patients received aspirin, 100 % thienopyridines, 80 % angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers, 87 % β-blockers, 96 % statins, and 65 % the combination of all 5 agents. ST-segment elevation myocardial infarction, hypertension, hypercholesterolaemia, and enrolment in an interventional centre were positive independent predictors of 5-drug combination therapy at discharge. Negative independent predictors were unstable angina and advanced age.
  
  
  CONCLUSIONS
  Current data from the CCR registry reflect a high quality of care for ACS discharge management in the Rotterdam-Rijnmond region. However, potential still remains for further optimisation.
authors.affiliation: Department of Cardiology, Erasmus MC, Thoraxcentre, Room Ee-2355, Dr. Molewaterplein 50-60, 3015 GE, Rotterdam, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Yetgin
authors.forename: M M J M
authors.initials: MM
authors.lastname: van der Linden
authors.forename: A G
authors.initials: AG
authors.lastname: de Vries
authors.forename: P C
authors.initials: PC
authors.lastname: Smits
authors.forename: R
authors.initials: R
authors.lastname: van Mechelen
authors.forename: S C
authors.initials: SC
authors.lastname: Yap
authors.forename: E
authors.initials: E
authors.lastname: Boersma
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
authors.forename: R-J M
authors.initials: RJ
authors.lastname: van Geuns