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Observational Study
. 2016 Aug;69(8):754-9.
doi: 10.1016/j.rec.2015.12.021. Epub 2016 Mar 12.

Changes in Acute Coronary Syndrome Treatment and Prognosis After Implementation of the Infarction Code in a Hospital With a Cardiac Catheterization Unit

[Article in English, Spanish]
Alberto Cordero  1 , Ramón López-Palop  2 , Pilar Carrillo  2 , Araceli Frutos  2 , Sandra Miralles  2 , Clara Gunturiz  2 , María García-Carrilero  2 , Vicente Bertomeu-Martínez  2
Affiliations
Observational Study

Changes in Acute Coronary Syndrome Treatment and Prognosis After Implementation of the Infarction Code in a Hospital With a Cardiac Catheterization Unit

[Article in English, Spanish]
Alberto Cordero et al. Rev Esp Cardiol (Engl Ed). 2016 Aug.

Abstract

Introduction and objectives: Emergency care systems have been created to improve treatment and revascularization in myocardial infarction but they may also improve the management of all patients with acute coronary syndrome.

Methods: A comparative study of all patients admitted with acute coronary syndrome before and after implementation of an infarction protocol.

Results: The study included 1210 patients. While the mean age was the same in both periods, the patient group admitted after implementation of the protocol had a lower prevalence of diabetes mellitus and hypertension but more active smokers and higher GRACE scores. The percentage of ST-segment elevation acute coronary syndrome (29.8%-39.5%) and coronary revascularizations (82.1%-90.1%) significantly increased among patients admitted with acute coronary syndrome, and primary angioplasty became routine (51.9%-94.9%); there was also a reduction in time to catheterization and an increase in early revascularization. The mean hospital stay was significantly shorter after implementation of the infarction protocol. In-hospital mortality was unchanged, except in high-risk patients (38.8%-22.4%). After discharge, no differences were observed between the 2 periods in cardiovascular mortality, all-cause mortality, reinfarction, or major cardiovascular complications.

Conclusions: After implementation of the infarction protocol, the percentage of patients admitted with ST-segment elevation acute coronary syndrome and the mean GRACE score increased among patients admitted with acute coronary syndrome. Hospital stay was reduced, and primary angioplasty use increased. In-hospital mortality was reduced in high-risk patients, and prognosis after discharge was the same in both periods.

Keywords: Acute coronary syndrome; Código infarto; Infarction code; Mortalidad; Mortality; Revascularización; Revascularization; Síndrome coronario agudo.

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