title: Contemporary antithrombotic strategies in patients with acute coronary syndrome admitted to cardiac care units in Italy: The EYESHOT Study.
abstract: BACKGROUND
  Several new antithrombotic therapies have emerged for the treatment of acute coronary syndrome (ACS). We sought to assess contemporary patterns of antithrombotic therapies use in patients with ACS.
  
  
  RESULTS
  EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in patients admitted to intensive cardiac care units (CCUs) for an ACS in Italy. Over a three-week period, 203 CCUs enrolled 2585 consecutive patients: 41.2% with ST-elevation myocardial infarction (STEMI) and 58.8% with non-ST elevation ACS (NSTE-ACS). During hospitalisation, low-molecular-weight heparins, aspirin, and clopidogrel were the most commonly used antithrombotic therapies. Among patients treated with percutaneous coronary intervention (PCI, n=1755), any crossover of heparin therapy occurred in 30.8% of cases, while switching from one P2Y12 inhibitor to another occurred in 3.6% of cases in the CathLab and in 14.2% before discharge. Of the 790 patients who did not receive revascularisation, switching of a P2Y12 inhibitor occurred in 5.7% of cases. At discharge, a new P2Y12 inhibitor (ticagrelor or prasugrel) in association with aspirin was prescribed in 59.5% of STEMI and 33.9% of NSTE-ACS patients: the most powerful predictor for prescription was PCI (odds ratio (OR) 6.18; 95% confidence interval (CI) 4.76-8.01; p<0.0001), whereas age ≥ 75 years was strongly associated with clopidogrel use (OR 0.28; 95% CI 0.22-0.36; p<0.0001).
  
  
  CONCLUSIONS
  The EYESHOT registry shows the current pattern of antithrombotic treatments for ACS patients admitted to Italian CCUs and provides insights which may help to improve the clinical care of such patients.
authors.affiliation: Department of Cardiovascular Sciences, European Hospital, Italy leo.deluca@libero.it centrostudi@anmco.it.
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Leonardi
authors.affiliation: Division of Cardiology, Santa Maria della Misericordia Hospital, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cavallini
authors.affiliation: ANMCO Research Centre, Italy.
authors.forename: Donata
authors.initials: D
authors.lastname: Lucci
authors.affiliation: Cardiovascular Department, AO Papa Giovanni XXIII, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
authors.affiliation: Division of Interventional Cardiology, Ospedale Civile dell'Annunziata, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Caporale
authors.affiliation: Division of Cardiology, S. Antonio Abate Hospital, Italy.
authors.forename: Maurizio G
authors.initials: MG
authors.lastname: Abrignani
authors.affiliation: Division of Cardiology, Maggiore della Carità Hospital, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lupi
authors.affiliation: Division of Cardiology, Cattinara Hospital, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Rakar
authors.affiliation: Division of Cardiology, Garibaldi-Nesima Hospital, Italy.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Gulizia
authors.affiliation: Cardiology Division, Campo di Marte Hospital, Italy.
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Bovenzi
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Servi
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000008:administration & dosage / Q000627:therapeutic use; D015897:Comorbidity; D017023:Coronary Angiography; D003325:Coronary Care Units; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D012042:Registries; D012307:Risk Factors
chemical_list: D000991:Antithrombins; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists
keywords: Acute coronary syndrome; antithrombotic therapy; bivalirudin; heparins; prasugrel; ticagrelor