Turk Kardiyol Dern Ars. 2018; 46(3): 175-183 | 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 Epicor Study Group11
Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey2
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
OBJECTIVE The aim of this study was to evaluate the long-term, post-discharge follow-up of antithrombotic management patterns (AMPs), clinical outcomes, and real-life health status of patients hospitalized acute coronary syndrome (ACS).
METHODS A total of 1034 patients hospitalized for ACS within 24 hours of symptom onset who survived to discharge were included. Of those, 514 had ST-segment elevation myocardial infarction (STEMI) and 520 had unstable angina (UA)/non-STEMI (NSTEMI). Data on follow-up AMPs, clinical outcomes, and health status were collected during 24 months of follow-up.
RESULTS The overall all-cause mortality was 6.4% (6.7% in UA/NSTEMI and 6.0% in STEMI patients), cardiovascular (CV) events had 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 after discharge. EuroQol-visual analogue scales scores increased from 78.9 to 81.6 in STEMI patients, and from 76.0 to 76.2 in UA/NSTEMI patients. Discharge and 2-year post-discharge scores for the EuroQol-5D index were 0.7 and 0.9, respectively in STEMI patients, while it was 0.8 for each period in UA/STEMI patients. Overall, 57.5% of the patients on dual antiplatelet (AP) therapy at discharge remained on this treatment at 2 years after discharge. The use of 1AP/0 anticoagulant (AC) and ≥2AP/0AC were associated with a CV event risk of 10.5% and 8.9%, a mortality risk of 10.5% and 5.8%, and a bleeding event risk of 0.9% and. 2.2%, respectively.
CONCLUSION These findings in a real-life population of ACS patients emphasize the importance of longer-term follow-up of ACS patients surviving hospitalization and support the likelihood of more favorable long-term outcomes in ACS management with the current treatment practices.
Acute coronary syndrome, antithrombotic management; non-ST-segment elevation myocardial infarction; real-life setting; ST-segment elevation myocardial infarction; Turkey.
How to cite this article
Fatih Sinan Ertaş, Lale Tokgozoglu, On Behalf Of The Epicor Study Group. Long-term follow-up of antithrombotic management patterns in acute coronary syndrome patients. Turk Kardiyol Dern Ars. 2018; 46(3): 175-183
Corresponding Author: Fatih Sinan Ertaş, Türkiye