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. 2019 Jan;35(1):1-10.
doi: 10.6515/ACS.201901_35(1).20180716B.

Changing Practice Pattern of Acute Coronary Syndromes in Taiwan from 2008 to 2015

Yi-Heng Li  1 , Yu-Wei Chiu  2 , Jun-Jack Cheng  3 , I-Chang Hsieh  4 , Ping-Han Lo  5 , Meng-Huan Lei  6 , Kwo-Chang Ueng  7 , Fu-Tien Chiang  8 , Shih-Hsien Sung  9 , Jen-Yuan Kuo  10 , Ching-Pei Chen  11 , Wen-Ter Lai  12 , Wen-Lieng Lee  13 , Jyh-Hong Chen  14 ; Taiwan Acute Coronary Syndrome Registry Investigators
Affiliations

Changing Practice Pattern of Acute Coronary Syndromes in Taiwan from 2008 to 2015

Yi-Heng Li et al. Acta Cardiol Sin. 2019 Jan.

Abstract

Background: Patients with acute coronary syndrome (ACS), including ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation (NSTE)-ACS have a significant risk of morbidity and mortality. This study evaluated the practice patterns of ACS care in Taiwan from 2005 to 2018.

Methods: Data from two nationwide ACS registries (2008-2010 and 2012-2015) were used. ACS patients who received percutaneous coronary interventions (PCIs) during admission were compared between the two registries.

Results: In STEMI, the door-to-balloon time for primary PCI decreased by 25 min from a median of 96 to 71 min (p < 0.0001) from the first to second registry. More complex PCI procedures and drug-eluting stents were used for ACS. However, the onset-to-door time was still long for both STEMI and NSTE-ACS. The D2B time for NSTE-ACS was long, especially in the elderly and female patients. Although the prescription rate of secondary preventive medications for ACS increased, it was still relatively low compared with Western data, especially in NSTE-ACS.

Conclusions: The registry data showed that ACS care quality has improved in Taiwan. However, areas including onset-to-door time and use of secondary preventive medications still need further improvements.

Keywords: Acute coronary syndromes; Quality; Taiwan.

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Figures

Figure 1
Figure 1
The median onset-to-door time in all STEMI patients, elderly patients (age ≥ 75 years) and female patients. * p < 0.05 compared with all STEMI patients. STEMI, ST segment elevation myocardial infarction.
Figure 2
Figure 2
The median D2B time in all STEMI patients, elderly patients (age ≥ 75 years), female patients and anterior MI patients in the first and second registry. * p < 0.05 compared with the first registry. D2B, door-to-balloon; MI, myocardial infarction; STEMI, ST segment elevation myocardial infarction.
Figure 3
Figure 3
The percentage of STEMI patients that received DAPT (A), ACEI or ARB (B), beta blocker (C) and statin (D) during hospitalization in the first and second registry. * p < 0.05 compared with the first registry. ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; DAPT, dual antiplatelet therapy; STEMI, ST segment elevation myocardial infarction.
See this image and copyright information in PMC

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