https://scholars.lib.ntu.edu.tw/handle/123456789/551661
Title: | Predictors of 1-year outcomes in the Taiwan Acute Coronary Syndrome Full Spectrum Registry | Authors: | FU-TIEN CHIANG Shyu K.-G. Wu C.-J. Mar G.-Y. Hou C.J.Y. Li A.-H. Wen M.-S. Lai W.-T. Lin S.-J. Kuo C.-T. Kuo C. Li Y.-H. HWANG, JUEY-JEN ACS Full Spectrum Registry Investigators |
Issue Date: | 2014 | Journal Volume: | 113 | Journal Issue: | 11 | Start page/Pages: | 794-802 | Source: | Journal of the Formosan Medical Association | Abstract: | Background/Purpose: Evidence-based guidelines have been formulated for optimal management of acute coronary syndrome (ACS). The Taiwan ACS Full Spectrum Registry aimed to evaluate the ACS management and identify the predictors of clinical outcomes of death/myocardial infarction/stroke 1year post hospital discharge. Methods: Three thousand and eighty confirmed ACS patients enrolled in this registry were followed up for 1year at 3-month intervals. Patient data on medical interventions as well as clinical events were recorded and analyzed by descriptive statistics. Results: One-year mortality among patients with ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and unstable angina was 6.1%, 10.1%, and 6.2%, respectively. Use of secondary preventive therapies was suboptimal throughout the follow-up phase, especially dual antiplatelet therapy, which fell from 74.8% patients at discharge to 24.9% patients at 1-year follow-up. The odds of an adverse incidence of death/myocardial infarction/stroke 1year after discharge was significantly reduced in patients receiving aspirin and clopidogrel for ?9months and was consequently higher in patients in whom dual antiplatelet therapy was discontinued or prescribed for <9months. Chronic renal failure, in-hospital bleeding, a diagnosis of NSTEMI, and antiplatelet therapy discontinuation had a negative association with 1-year outcomes, whereas the use of drug-eluting stents and antiplatelet agents, clopidogrel and aspirin, were predictors of positive outcomes. Conclusion: There is a significant deviation from evidence-based guidelines in ACS management in Taiwan as reported in other countries. Policy adherence, especially with regard to dual antiplatelet therapy may hold the key to long-term favorable outcomes and improved survival rates in ACS patients in Taiwan. ? 2013 . |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/551661 | ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2013.08.001 | SDG/Keyword: | acetylsalicylic acid; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; calcium channel blocking agent; clopidogrel; dipeptidyl carboxypeptidase inhibitor; hydroxymethylglutaryl coenzyme A reductase inhibitor; acetylsalicylic acid; antithrombocytic agent; clopidogrel; ticlopidine; acute coronary syndrome; adult; anticoagulant therapy; Article; cardiovascular mortality; cerebrovascular accident; chronic kidney failure; coronary artery bypass graft; drug eluting stent; drug withdrawal; female; follow up; heart infarction; hospital discharge; hospitalization; human; major clinical study; male; middle aged; non ST segment elevation myocardial infarction; outcome assessment; percutaneous coronary intervention; practice guideline; secondary prevention; ST segment elevation myocardial infarction; Taiwan; treatment duration; unstable angina pectoris; acute coronary syndrome; aged; analogs and derivatives; mortality; Myocardial Infarction; prognosis; register; Stroke; treatment outcome; Acute Coronary Syndrome; Aged; Aspirin; Drug-Eluting Stents; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myocardial Infarction; Patient Discharge; Platelet Aggregation Inhibitors; Prognosis; Registries; Stroke; Taiwan; Ticlopidine; Treatment Outcome |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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