title: Epidemiological characteristics, management and early outcomes of acute coronary syndromes in Greece: The PHAETHON study.
abstract: BACKGROUND
  In view of recent therapeutic breakthroughs in acute coronary syndromes (ACS) and essential demographic and socioeconomic changes in Greece, we conducted the prospective, multi-center, nationwide PHAETHON study (An Epidemiological Cohort Study of Acute Coronary Syndromes in the Greek Population) that aimed to recruit a representative cohort of ACS patients and examine current management practices and patient prognosis.
  
  
  METHODS
  The PHAETHON study was conducted from May 2012 to February 2014. We enrolled 800 consecutive ACS patients from 37 hospitals with a proportional representation of all types of hospitals and geographical areas. Patients were followed for a median period of 189 days. Outcome was assessed with a composite endpoint of death, myocardial infarction, stroke, urgent revascularization and urgent hospitalization for cardiovascular causes.
  
  
  RESULTS
  The mean age of patients was 62.7 years (78% males). The majority of patients (n=411, 51%) presented with ST-elevation myocardial infarction (STEMI), whereas 389 patients presented with NSTEMI (n=303, 38%) or UA (n=86, 11%). Overall, 58.8% of the patients had hypertension, 26.5% were diabetic, 52.5% had dyslipidemia, 71.1% had a smoking history (current or past), 25.8% had a family history of coronary artery disease (CAD) and 24.1% had a prior history of CAD. In STEMI patients, 44.5% of patients were treated with thrombolysis, 38.9% underwent a coronary angiogram (34.1% were treated with primary percutaneous coronary intervention) and 16.5% did not receive urgent treatment. The pain-to-door time was 169 minutes. During hospitalization, 301 (38%) patients presented one or more complications, and 13 died (1.6%). During follow-up, 99 (12.6%) patients experienced the composite endpoint, and 21 died (2.7%).
  
  
  CONCLUSIONS
  The PHAETHON study provided valuable insights into the epidemiology, management and outcome of ACS patients in Greece. Management of ACS resembles the management observed in other European countries. However, several issues still to be addressed by public authorities for the timely and proper management of ACS.
authors.affiliation: Henry Dunant Hospital Center, Athens, Greece. Electronic address: andrikop@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Andrikopoulos
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Terentes-Printzios
authors.affiliation: Henry Dunant Hospital Center, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Tzeis
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Vlachopoulos
authors.affiliation: University of Athens Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Varounis
authors.affiliation: AstraZeneca SA, Medical Department, Athens, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Nikas
authors.affiliation: University of Athens Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Lekakis
authors.affiliation: Cardiology Clinic, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Stakos
authors.affiliation: Cardiology Department, Sotiria Chest Diseases Hospital, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Lymperi
authors.affiliation: Cardiology Department, General Hospital of Kavala, Kavala, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Symeonidis
authors.affiliation: Cardiology Department, Tripoli General Hospital, Tripoli, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Chrissos
authors.affiliation: Department of Cardiology, 2nd IKA Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Kyrpizidis
authors.affiliation: Department of Cardiology, Patras University Hospital, Patras, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Alexopoulos
authors.affiliation: Department of Cardiology, General Hospital of Messinia, Kalamata, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Zombolos
authors.affiliation: Cardiology Department, Tzaneio State Hospital, Piraeus, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Foussas
authors.affiliation: Cardiology Department, Western Attica General Hospital of Athens, Greece.
authors.forename: Α
authors.initials: Α
authors.lastname: Κranidis
authors.affiliation: Cardiology Department, General Hospital of Edessa, Edessa, Greece.
authors.forename: Κ
authors.initials: Κ
authors.lastname: Oikonomou
authors.affiliation: First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Third Department of Cardiology, Hippokration University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Vasilikos
authors.affiliation: Department of Cardiology, Vostanion Hospital, Mytilini, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Andronikos
authors.affiliation: Department of Cardiology, Venizelio General Hospital, Crete, Greece.
authors.forename: Α
authors.initials: Α
authors.lastname: Dermitzakis
authors.affiliation: Second Department of Cardiology, Athens Euroclinic, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Richter
authors.affiliation: Third Cardiology Department, Hippokration Hospital, Aristotle University Medical School, Thessaloniki, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Fragakis
authors.affiliation: Department of Cardiology, General Hospital of Aigio, Aigio, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Styliadis
authors.affiliation: Department of Cardiology, General Hospital of Sparti, Lakonia, Sparti, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Mavridis
authors.affiliation: 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Stefanadis
authors.affiliation: Department of Cardiology, Heraklion University Hospital, Crete, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Vardas
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D000789:Angina, Unstable / Q000453:epidemiology*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072658:Non-ST Elevated Myocardial Infarction / Q000453:epidemiology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000453:epidemiology*
keywords: Acute coronary syndromes; Epidemiology; Myocardial infarction; Prognosis