title: Prognosis and management of acute coronary syndrome in Spain in 2012: the DIOCLES study.
abstract: OBJECTIVE
  To identify the current mortality and management of patients admitted for suspected acute coronary syndrome in Spain. The last available registry (2004-2005) reported an in-hospital mortality of 5.7%.
  
  
  METHODS
  The study included patients consecutively admitted between January and June 2012 at 44 hospitals selected at random. Information was collected on clinical course at admission and on events at 6 months.
  
  
  RESULTS
  A total of 2557 patients admitted with suspected acute coronary syndrome were included: 788 (30.8%) with ST-segment elevation, 1602 (62.7%) without ST-segment elevation, and 167 (6.5%) with unclassified acute coronary syndrome. In-hospital mortality was 4.1% (6.6%, 2.4%, and 7.8% respectively), significantly lower than that observed for 2004-2005. Reperfusion treatment (most commonly, primary percutaneous coronary intervention) was administered to 85.7% of patients with ST-segment elevation attended within 12h. The median time from first medical contact to thrombolysis was 40 min and to balloon inflation, 120 min. Among patients without ST-segment elevation, coronary angiography was performed in 80.6%, percutaneous intervention in 52.0%, and surgery was indicated in 6.4%. Secondary prevention treatments at discharge was prescribed more often than in earlier registries. In patients alive at discharge (follow-up available for 97.1%), 6-month mortality was 3.8%.
  
  
  CONCLUSIONS
  Mortality among patients with acute coronary syndrome in Spain was lower than that reported in the most recent published studies, in parallel with a more frequent use of the main treatments recommended.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Vall d'Hebron, VHIR, Universidad Autónoma de Barcelona, Barcelona, Spain. Electronic address: jabarrabes@vhebron.net.
authors.forename: José A
authors.initials: JA
authors.lastname: Barrabés
authors.affiliation: Servicio de Cardiología, Hospital Universitario de Tarragona Joan XXIII, IIISPV, Universidad Rovira Virgili, Tarragona, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Bardají
authors.affiliation: IBSAL-Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Jiménez-Candil
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain.
authors.forename: Frutos
authors.initials: F
authors.lastname: del Nogal Sáez
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario, Universidad de Valencia, Incliva, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodí
authors.affiliation: Servicio de Cardiología, Hospital de Navarra, Pamplona, Navarra, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Basterra
authors.affiliation: Sección de Cardiología, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain.
authors.forename: Elvira
authors.initials: E
authors.lastname: Marco
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Melgares
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario La Fe, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Cuñat de la Hoz
authors.affiliation: Servicio de Cardiología, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Ortiz
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003430:Cross-Sectional Studies; D019468:Disease Management; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
keywords: Angina inestable; Infarto de miocardio; Myocardial infarction; Prognosis; Pronóstico; Registro; Registry; Supervivencia; Survival; Unstable angina