1 / 32

Pharmacotherapy in acute coronary syndromes

Pharmacotherapy in acute coronary syndromes. Perspective from first line and regional hospitals in Czech Republic. Petr Jansky. Cardionale , 26.11.2010. Pilot MI registry ( n=3188 ) 6 non PCI hospitals Discharge pharmacotherapy. Svobodová , 2008. CZECH registry. All ACS patients

flint
Télécharger la présentation

Pharmacotherapy in acute coronary syndromes

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Pharmacotherapyin acutecoronarysyndromes Perspectivefromfirst line andregionalhospitalsin CzechRepublic Petr Jansky Cardionale, 26.11.2010

  2. Pilot MI registry (n=3188)6 non PCI hospitalsDischargepharmacotherapy Svobodová, 2008

  3. CZECH registry All ACS patients 11/2005 N 1921 1/ all PCI hospitals (80%) 2/ allcommunityhospitals in tworegions (20%) Widimský P. etal., IntJ Cardiol, 2007

  4. Dischargepharmacotherapy STEMI % Mandelzweig, EHJ, 2006 Widimský, Int J Cardiol, 2007

  5. DischargepharmacotherapynonSTE ACS % Widimský, Int J Cardiol, 2007

  6. Recommendations for performance measures • Development of regional and/or national programmes to systematically measure performance indicators and provide feedback to individual hospitals is strongly encouraged (I-C). European Heart Journal, July 2007

  7. Confirmedacutecoronarysyndromes (STEMI, NONSTEMI, unstableAP) • Continuallysince 1.7.2008 • 32 non cathhospitals

  8. Qualityofpharmacotherapy • Prehospitalphase • Earlyhospitalphase • On discharge

  9. Patientcharacteristics 7/2008-3/2010

  10. Prehospitalpharmacotherapy

  11. PrehospitalpharmacotherapyEMS vsphysician

  12. Prehospitalpharmacotherapy

  13. Evidence-based medical therapy (heparin, ASA, BB, statin, thienopyridin) within the first 24 hours after admissionis associated with lower in-hospital mortality in NSTEMI % N 1889, p < 0,001 Monhartetal., ESC 2008

  14. Pharmacotherapywithin 24 hoursafteradmission Aspirin Lineartrend:n.s.

  15. Pharmacotherapywithin24 hoursafteradmission Betablockers Lineartrend:n.s.

  16. Pharmacotherapywithin 24 hoursafteradmission Clopidogrel Lineartrend:p=0,023

  17. Pharmacotherapywithin24 hoursafteradmission Statin Linear trend:p<0,001

  18. Pharmacotherapywithin24 hoursafteradmission LMWH Lineartrend:n.s.

  19. Pharmacotherapywithin24 hoursafteradmission Heparin Lineartrend:p=0,036

  20. Pharmacotherapywithin24 hoursafteradmission Fondaparinux Lineartrend:p=0,011

  21. Pharmacotherapywithin24 hoursafteradmission * p<0,05; ** p<0,01; *** p<0,001

  22. Dischargepharmacotherapy Aspirin Lineartrend:n.s.

  23. Dischargepharmacotherapy Clopidogrel Lineartrend:n.s.

  24. Clopidogrelon discharge – individualhospitals

  25. Dischargepharmacotherapy Betablockers Lineartrend:n.s.

  26. Betablockers on discharge – individualhospitals

  27. Dischargepharmacotherapy ACEI Lineartrend:p=0,012

  28. Dischargepharmacotherapy Statin Lineartrend:p<0,001

  29. Dischargepharmacotherapy Combination(aspirin, clopidogrel, BB, ACEI, statin) Lineartrend:p=0,010

  30. Dischargepharmacotherapy * p<0,05; ** p<0,01; *** p<0,001

  31. Conclusion • Unsatisfactoryprehospitalpharmacotherapy • In-hospitalpharmacotherapyisrelativelygood (exc. elderly, females, NONSTEMI) • Interhospital variability in thequalityof care • Improvement in somerecommendedtherapies(statins, clopidogrelin theacutephase) overshorttime period

  32. Thankyouforyourattention !

More Related