Turk Kardiyol Dern Ars. Ahead of Print: TKDA-66724 | DOI: 10.5543/tkda.2017.66724
Long-term follow-up of antithrombotic management patterns in acute coronary syndrome patients
Fatih Sinan Ertaş1
, Lale Tokgozoglu2
, On Behalf Of The Epıcor Study Group11
Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey2
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
OBJECTIVE To evaluate post-discharge long-term follow-up of antithrombotic management patterns (AMPs), clinical outcomes and health status in a real-life setting for hospitalized acute coronary syndrome (ACS) patients.
METHODS A total of 1034 patients (514 with STEMI and 520 with UA/NSTEMI) hospitalized for ACS within 24-h of symptom onset and survived to discharge were included. Data on follow-up AMPs, clinical outcomes and health status were collected during 24-month follow-up.
RESULTS Overall all-cause mortality was 6.4% (6.7% in UA/NSTEMI and 6.0% in STEMI patients), cardiovascular (CV) events occurred in 9.4% (9.8% in UA/NSTEMI and 8.9% in STEMI patients) and bleeding events in 2.0% (2.3% in STEMI and 1.7% in UA/NSTEMI patients) of patients at 2 years post-discharge. EQ VAS scores were increased from 78.9 to 81.6 in STEMI, while from 76.0 to 76.2 in UA/NSTEMI patients. Discharge and 2- year post-discharge scores for EQ-5D index were 0.7 and 0.9, respectively in STEMI patients, while 0.8 for each period in UA/STEMI patients. Overall, 57.5% of the patients on dual antiplatelet therapy at discharge remained on these treatments for 2 years. Use of 1AP/0 anticoagulant (AC) and ≥2AP/0AC were associated with CV event risk of 10.5% and 8.9%, mortality risk of 10.5% and 5.8% and bleeding event risk of 0.9% and. 2.2%, respectively.
CONCLUSIONS Our findings in a real-life population of ACS patients emphasize the importance of longer-term follow-up in ACS patients surviving hospitalization and support the likelihood of a more favorable long-term outcome via current treatment practices in ACS management.
Acute coronary syndrome, ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, antithrombotic management, real-life setting, Turkey
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Corresponding Author: Fatih Sinan Ertaş, Türkiye