title: Pre-hospital management of acute coronary syndrome patients in Belgium and Luxembourg and other Western European countries.
abstract: OBJECTIVE
  This sub-analysis of the EPICOR study describes pre-hospital care (PHC) patterns in Belgium, Luxembourg (Belux) and Western European (WEU) countries (Finland, Norway, Denmark, the Netherlands, UK, Belgium, Luxembourg, Spain, France, Italy, Greece and Germany.
  
  
  RESULTS
  EPICOR (NCT01171404) is multinational, observational study comprising patients with acute coronary syndrome hospitalized within 24h of symptoms onset, diagnosed with ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) or unstable angina (UA). Of the 325 WEU centres, 37 were in Belgium and 1 in Luxembourg. PHC was defined as pre-hospital ECG and/or pre-hospital medication (PHM). 504 Belux and 6,119 WEU patients were enrolled. Of the WEU patients 51.5% received PHC and 28.1% PHM, compared to 27.6% and 11.3% of the Belux patients. These differences were observed in both STEMI and UA/NSTEMI patients. In Belux, the most frequent PHM was acetylsalicylic acid (53 patients); only 1 patient received thrombolytics. The median time from symptoms onset to ECG was longer for Belux (2.8 h) than for WEU patients (2.4 h). PHC shortened this time by almost 1.5h. Belux patients with PHC had a shorter median time between symptoms onset and first medical attention (FMA) than WEU patients (1.0 vs 1.3 h). Only 34.7% of Belux patients with pre-hospital ECG and with time from FMA to ECG available had ECG within 10 minutes of FMA, as recommended by the European Society of Cardiology.
  
  
  CONCLUSIONS
  In Belux, diagnostic ECG is delayed compared to WEU, despite the short time to FMA. Few patients undergo ECG within the recommended period, indicating room for improvement.
authors: Christophe
authors: C
authors: Beauloye
authors: Mathias
authors: M
authors: Vrolix
authors: Marc J
authors: MJ
authors: Claeys
authors: Philippe
authors: P
authors: van de Borne
authors: Eef
authors: E
authors: Vandendriessche
authors: Frans
authors: F
authors: Van De Werf
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D000789:Angina, Unstable / Q000175:diagnosis / Q000188:drug therapy*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D001530:Belgium; D002309:Cardiology; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005060:Europe; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008189:Luxembourg; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005343:Fibrinolytic Agents; D001241:Aspirin
keywords: Belgium; EPICOR; Luxembourg; STEMI; acute coronary syndrome; pre-hospital management