Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jan;22(1):20-7.
doi: 10.1007/s12471-013-0484-x.

Current discharge management of acute coronary syndromes: data from the Rijnmond Collective Cardiology Research (CCR) study

T Yetgin  1 , M M J M van der Linden, A G de Vries, P C Smits, R van Mechelen, S C Yap, E Boersma, F Zijlstra, R-J M van Geuns; CCR Study Investigators
Affiliations

Current discharge management of acute coronary syndromes: data from the Rijnmond Collective Cardiology Research (CCR) study

T Yetgin et al. Neth Heart J. 2014 Jan.

Abstract

Background: Medical discharge management of acute coronary syndromes (ACS) remains suboptimal outside randomised trials and constitutes an essential quality benchmark for ACS. We sought to evaluate the rates of key guideline-recommended pharmacological agents after ACS and characteristics associated with optimal treatment at discharge.

Methods: The Rijnmond Collective Cardiology Research (CCR) registry is an ongoing prospective, observational study in the Netherlands that aims to enrol 4000 patients with ACS. We examined discharge and 1-month follow-up medication use among the first 1000 patients enrolled in the CCR registry. Logistic regression was performed to identify patient and hospital characteristics associated with collective guideline-recommended pharmacotherapy at hospital discharge.

Results: At discharge, 94 % of patients received aspirin, 100 % thienopyridines, 80 % angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers, 87 % β-blockers, 96 % statins, and 65 % the combination of all 5 agents. ST-segment elevation myocardial infarction, hypertension, hypercholesterolaemia, and enrolment in an interventional centre were positive independent predictors of 5-drug combination therapy at discharge. Negative independent predictors were unstable angina and advanced age.

Conclusion: Current data from the CCR registry reflect a high quality of care for ACS discharge management in the Rotterdam-Rijnmond region. However, potential still remains for further optimisation.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Medication use at discharge and 1-month follow-up according to ACS spectrum. *P < 0.05. ACE-I/ARB indicates angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker; ACS, acute coronary syndrome; NSTEMI, non-ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction; and UA, unstable angina
Fig. 2
Fig. 2
Institutional discharge prescription rates. ACE-I/ARB indicates angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker
Fig. 3
Fig. 3
Institutional follow-up prescription rates. ACE-I/ARB indicates angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Eagle KA, Montoye CK, Riba AL, et al. Guideline-based standardized care is associated with substantially lower mortality in medicare patients with acute myocardial infarction: the American College of Cardiology’s Guidelines Applied in Practice (GAP) Projects in Michigan. J Am Coll Cardiol. 2005;46(7):1242–1248. doi: 10.1016/j.jacc.2004.12.083. - DOI - PubMed
    1. Melloni C, Newby LK. Risk factor management after acute coronary syndromes. Heart. 2009;95(17):1382–1384. doi: 10.1136/hrt.2009.166595. - DOI - PubMed
    1. Hamm CW, Bassand JP, Agewall S, et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: the task force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) Eur Heart J. 2011;32(23):2999–3054. doi: 10.1093/eurheartj/ehr236. - DOI - PubMed
    1. Wijns W, Kolh P, Danchin N, et al. Guidelines on myocardial revascularization. Eur Heart J. 2010;31(20):2501–2555. doi: 10.1093/eurheartj/ehq277. - DOI - PubMed
    1. Steg PG, James SK, Atar D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569–2619. doi: 10.1093/eurheartj/ehs215. - DOI - PubMed

LinkOut - more resources