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European Heart Journal 2002 23(13):1021-1029; doi:10.1053/euhj.2001.2974
Copyright © 2002 by the European Society of Cardiology.
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First national survey on management strategies in non ST-elevation acute ischaemic syndromes in Argentina. Results of the STRATEG–SIA study

E.R. Ferreirósf1, R. Kevorkian, J.J. Fuselli, J. Guetta, C.P. Boissonnet, D. di Toro, R. Cragnolino, O. Masoli, A. Cagide and J. Krauss

Area de Investigación, Sociedad Argentina de Cardiología, Buenos Aires, Argentina

revised August 20, 2001; accepted August 22, 2001

Abstract

Aims To assess the management strategies applied in non-ST elevation acute ischaemic syndromes in Argentina, the factors influencing the choice of treatment, and their relationship to short- and long-term (1 year) patient outcomes.

Methods and Results We conducted a 1 month, prospective, population-based survey in 77 hospitals (all over the country). We recruited 492 patients (age 63·9±11·7 years, male sex 68·3%, and 59·8% acute ischaemic ECG changes). Subjects were stratified according to the AHCPR classification as: high risk 62·2%, intermediate 25·0% and low 12·8%. At 1 year, the rate of death or myocardial infarction according to risk category and invasive procedures employed were: high risk (angioplasty 5·4% vs coronary artery bypass grafting 12·1% vs medical treatment 17·2%;P =0·001), intermediate risk (angioplasty 5·7% vs coronary artery bypass grafting 12·5% vs medical treatment 4·7%, P=ns), and low risk (angioplasty 10·0% vs coronary artery bypass grafting 15·2% vs medical treatment 1·9%; P<0·001). In the overall population, the 1 year event rate was not significantly different between the invasive and medical treatment groups (11·5% vs 7·2%, P=0·09).

Conclusions A routine, unselected invasive approach in non-ST elevation acute ischaemic syndromes in Argentina is associated with no apparent improvement of patients' outcome. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Unstable angina, myocardial infarction, management strategies

f1 Correspondence: Ernesto R. Ferreirós, Area de Investigación, Sociedad Argentina de Cardiología. Azcuénaga 980, Ciudad de Buenos Aires, Argentina.

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