title: The incidence and outcomes of acute coronary syndromes in a central European country: results of the CZECH-2 registry.
abstract: BACKGROUND
  The incidence and treatment strategies of acute coronary syndrome (ACS) vary by region. Additionally, the clinical spectrum of ACS is changing and outcomes are improving.
  
  
  OBJECTIVE
  We assessed the incidence, treatment strategies, and outcomes of ACS for a well-defined population within a well-established network of percutaneous coronary intervention (PCI) centers and non-PCI centers.
  
  
  METHODS
  The CZECH-2 registry included 1221 consecutive patients (mean age: 68 ± 13 years; 63.4% males) admitted for suspected ACS to 32 hospitals (including 4 PCI centers) within four Czech counties (total population: 2,370,841 inhabitants) during a 2-month period.
  
  
  RESULTS
  The estimated incidence of confirmed ACS was 2,149 cases/million/year. In 374 (31%) patients, ACS was ruled out during the hospital stay. Coronary angiography (CAG) was performed in 60% of the patients overall and PCI was performed in 59% of the confirmed ACS patients. Killip classifications II-IV on admission were more common in patients with final diagnosis of non ST-elevation myocardial infarction (NSTEMI) than ST-elevation myocardial infarction (STEMI) (37.1% vs. 22.8%; p<0.001). The 30-day mortality rate was 5.7% for the whole study group, 7.3% for STEMI patients, 8.4% for NSTEMI patients, and 1.6% for patients with unstable angina pectoris (UAP), respectively.
  
  
  CONCLUSIONS
  Almost one-third of the patients admitted for suspected ACS had a different final diagnosis. Among those with confirmed ACS, the use of CAG, PCI, CABG, and effective medications is rational. Outcome in NSTEMI patients was equivalent to those in STEMI patients, mainly due to the high-risk population in this group.
authors.affiliation: Cardiocenter, Charles University Prague, Third Faculty of Medicine, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Tousek
authors.affiliation: Regional Hospital, Department of Cardiology, Ceske Budejovice, Czech Republic.
authors.forename: Frantisek
authors.initials: F
authors.lastname: Tousek
authors.affiliation: Cardiocenter, Hospital Liberec, Liberec, Czech Republic.
authors.forename: David
authors.initials: D
authors.lastname: Horak
authors.affiliation: Masaryk Hospital, Department of Cardiology, Usti nad Labem, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Cervinka
authors.affiliation: University Hospital Plzen, Faculty of Medicine Plzen, Charles University, Dept. of Cardiology, Plzen, Czech Republic.
authors.forename: Richard
authors.initials: R
authors.lastname: Rokyta
authors.affiliation: Regional Hospital, Department of Cardiology, Ceske Budejovice, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Pesl
authors.affiliation: Masaryk University, Faculty of Medicine, Institute for Biostatistics and Analysis, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
authors.affiliation: Cardiocenter, Charles University Prague, Third Faculty of Medicine, Prague, Czech Republic. Electronic address: petr.widimsky@fnkv.cz.
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Acute coronary syndrome; Incidence; Outcome; Registry