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. 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.

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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

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