The incidence, treatment strategies and outcomes of acute coronary syndromes in the “reperfusion network” of different hospital types in the Czech Republic: Results of the Czech evaluation of acute coronary syndromes in hospitalized patients (CZECH) registry

• Published in: International journal of cardiology 2007-07, Vol.119 (2), p.212-219
• Main Authors: Widimsky, Petr, Zelizko, Michal, Jansky, Petr, Tousek, Frantisek, Holm, Frantisek, Aschermann, Michael
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Acute myocardial infarction; Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Aged, 80 and over; Angina, Unstable - diagnosis; Angina, Unstable - epidemiology; Angina, Unstable - therapy; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Coronary Angiography; Coronary Artery Bypass; Coronary artery bypass surgery; Coronary heart disease; Czech Republic - epidemiology; Diseases of the cardiovascular system; Female; Heart; Hospital Mortality; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Incidence; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; Percutaneous coronary intervention; Pharmacotheraphy; Platelet Aggregation Inhibitors - therapeutic use; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Registries; Registry; Reperfusion; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Thrombolytic Therapy - methods; Treatment Outcome
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2007.02.036

Abstract Aims To analyze the incidence, treatment strategies and outcomes of acute coronary syndromes (ACS) in Czech population. Methods and results ACS diagnosis was confirmed in 1345 of 1921 (70%) consecutively admitted patients with suspected ACS. ACS incidence was 3248 cases/million/year and the annual incidence of confirmed myocardial infarction was 1960 per million. In-hospital mortality was 5.1% (10.0% with Q-MI, 4.4% with non-Q-MI, and 0.9% with UAP). Coronary angiography was performed in 92% of STEMI (followed by primary PCI in 83%, by CABG in 3%, by conservative therapy in 6%). Thrombolysis was used in only 1% of patients. Reperfusion therapy was thus used in 87% of all STEMI patients. Discharge medication included aspirin in 95%, a statin in 76%, a beta-blocker in 78%, an ACE inhibitor in 50%, clopidogrel in 60%, and ticlopidine in 4% of patients. Conclusions In-hospital mortality of ACS in the Czech network of PCI and non-PCI hospitals is low. Nationwide application of primary PCI strategy for STEMI is feasible and increases the overall use of reperfusion therapy.