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Arch Cardiovasc Dis. 2010 Aug-Sep;103(8-9):437-46. doi: 10.1016/j.acvd.2010.07.001. Epub 2010 Oct 27.

Observational study of adherence to European clinical practice guidelines for the management of acute coronary syndrome in revascularized versus non-revascularized patients - the CONNECT Study.

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  • 1Groupe Hospitalier Pitié-Salpétrière, Institut de Cardiologie, 47-83, boulevard de l'Hôpital, 75651 Paris Cedex 13, France.

Abstract

BACKGROUND:

The CONNECT study compared clinician adherence to guideline-recommended secondary prevention therapies prescribed at discharge for patients hospitalized for acute coronary syndrome (ACS) in those managed initially with percutaneous coronary intervention (PCI; revascularized) and those who did not undergo revascularization.

METHODS:

Patients aged greater than or equal to 18 years, hospitalized for a documented ST-segment elevation or non-ST-segment elevation ACS, were enrolled consecutively over 1 month at 238 sites in France.

RESULTS:

Compared with revascularized patients (n=870), non-revascularized patients (n=706) were significantly older, and a greater proportion were women, had high-blood pressure, type-2 diabetes or a history of atherothrombotic or cardiac disease, but a smaller proportion had a history of coronary angioplasty. On discharge, non-revascularized patients were prescribed beta-blockers, aspirin, statins, angiotensin-converting enzyme inhibitors or adenosine diphosphate receptor antagonists less frequently than revascularized patients. An adherence score greater than or equal to 80% (at least four of the five recommended agents prescribed at discharge) was found in 96.7% of revascularized patients and 74.4% of non-revascularized patients (P<0.001).

CONCLUSIONS:

Despite a similar or even higher level of cardiovascular risk, non-revascularized ACS patients were prescribed guideline-recommended secondary prevention therapy less frequently than revascularized patients.

2010 Elsevier Masson SAS. All rights reserved.

PMID:
21074122
[PubMed - indexed for MEDLINE]
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