title: Does treatment impact health outcomes for patients after acute coronary syndrome?
abstract: BACKGROUND
  Mortality rates for acute coronary syndrome (ACS) patients are still very high all over the world. Our study aimed to investigate the impact of ACS treatment on cardiovascular (CV) mortality eight years following ACS.
  
  
  METHODS
  A retrospective cohort study with a total of 613 patients was used. The data was collected from databases and medical records. An evidence-based treatment (EBT) algorithm was used based on the ESC guidelines. Logistic regression analysis and standardized odds ratios with 95% confidence interval (CI) were used for the risk assessment, with a p level<0.05 considered as significant.
  
  
  RESULTS
  The median follow-up time in this study was 7.6 years. During follow-up 48.9% of the patients (n=300) died from CV and 207 (69%) for a relevant reason. For monotherapy ACE inhibitors and β-blockers, and for fixed dose combined drugs ACE inhibitors and diuretics, were most frequently used. EBT was provided to 37.8% of patients. The EBT use (HR 0.541, CI 0.394-0.742, p<0.001) during follow-up period was important for reducing CV mortality in ACS patients.
  
  
  CONCLUSIONS
  The combined use of EBT significantly improved outcomes. The recurrent myocardial infarction and percutaneous coronary intervention patients were more frequent in EBT and it was beneficial for reducing CV mortality.
authors.affiliation: Department of Preventive Medicine, Lithuanian University of Health Sciences, 57-302 Šiaurės ave, Kaunas LT-49264, Lithuania. jelena0110@yahoo.com.
authors.forename: Jelena
authors.initials: J
authors.lastname: Umbrasienė
authors.affiliation: Department of Preventive Medicine, Lithuanian University of Health Sciences, 57-302 Šiaurės ave, Kaunas LT-49264, Lithuania. giedrius.vanagas@lsmuni.lt.
authors.forename: Giedrius
authors.initials: G
authors.lastname: Vanagas
authors.affiliation: Institute of Cardiology, Lithuanian University of Health Sciences, 17 Sukilėlių ave, Kaunas LT-50009, Lithuania. j.vencloviene@gmf.vdu.lt.
authors.forename: Jon
authors.initials: J
authors.lastname: Venclovienė
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: cardiovascular mortality; evidence-based treatment