European Heart Journal Advance Access originally published online on August 14, 2006
European Heart Journal 2006 27(19):2285-2293; doi:10.1093/eurheartj/ehl196
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The second Euro Heart Survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004
1 Neufeld Cardiac Research Institute, Sheba Medical Center, Tel Hashomer, Israel
2 Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
3 Department of Cardiology, Hospital General Universitario Gregorio Maranon, Madrid, Spain
4 Department of Cardiologie, Hopital Europeen Georges-Pompidou, Paris, France
5 Department of Cardiology, Atticon University Hospital, Athens, Greece
6 Herzzentrum Ludwigshafen, Institut fur Herzinfarktorschung, Ludwigshafen, Germany
7 Cardiovascular Institute, Poriah Medical Center, Tiberias, Israel
8 Lipids and Cardiovascular Epidemiology Unit, IMIM, Barcelona, Spain
9 Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium
10 Department of Cardiology, Uppsala Clinical Research Centre, Uppsala, Sweden
Received 16 January 2006; revised 29 June 2006; accepted 27 July 2006; online publish-ahead-of-print 14 August 2006.
* Corresponding author. Tel: +972 3 5344703; fax: +972 3 5342392. E-mail address: behar{at}sheba.health.gov.il
See page 2260 for the editorial comment on this article (doi:10.1093/eurheartj/ehl240)
Aims Our study aimed to examine the management of acute coronary syndromes (ACS) in Europe and the Mediterranean basin, and to compare adherence to guidelines with that reported in the first Euro Heart Survey on ACS (EHS–ACS-I), 4 years earlier.
Methods and results In a prospective survey conducted in 2004 (EHS–ACS-II), data describing the characteristics, treatment, and outcome of 6385 patients diagnosed with ACS in 190 medical centres in 32 countries were collected. ACS with ST-elevation was the initial diagnosis in 47% of patients, no ST-elevation in 48%, and undetermined electrocardiographic pattern in 5% of patients. Comparison of data collected in 2000 and 2004 showed similar baseline characteristics, but greater use of recommended medications and coronary interventions in EHS–ACS-II. Among patients with ST-elevation, the use of primary reperfusion increased slightly (from 56 to 64%), with a significant shift from fibrinolytic therapy to primary percutaneous coronary intervention (PPCI). The use of PPCI rose from 37 to 59% among those undergoing primary reperfusion therapy. Analysis of data in 34 centres that participated in both surveys showed even greater improvement with respect to the use of recommended medical therapy, interventions, and outcome.
Conclusion Data from EHS–ACS-II suggest an increase in adherence to guidelines for treatment of ACS in comparison with EHS–ACS-I.
Key Words: Acute coronary syndromes • Acute myocardial infarction • Unstable angina • Prognosis • Management
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