Home Cardiology Letters 2022 Cardiology Letters Vol.31, No.1, p.10–22, 2022

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Cardiology Letters Vol.31, No.1, p.10–22, 2022

Title: Aktuálne trendy v liečbe akútneho koronárneho syndrómu bez elevácií segmentov ST v Slovenskej republike: Analýza údajov registra SLOVAKS-2 z roku 2020 / Current treatment trends of the non-ST-segment elevation acute coronary syndrome in the Slovak Republi
Author: F. Kovář, V. Hricák, M. Studenčan, R. Alberty, M. Hudec, R. Hatala, P. Hlivák, E. Gonçalvesová

Abstract: Introduction: The SLOVAKS register collects and analyses data on patients with non-ST elevation acute coronary syndrome (NSTE-ACS) in the Slovak Republic.
Objective: Collection, analysis, and evaluation of NSTE-ACS patients’ data.
Methodology: Electronic reports from NSTE-ACS inpatients were collected during October and November 2020. Representative demographic and anamnestic variables, risk profiles, diagnostic and therapeutic management (conservative and invasive), and subsequent coronary revascularization were evaluated. Data for the whole cohort were evaluated; some analyses were also conducted with a focus on diabetes mellitus and gender.
Results: From the study period, 714 NSTE-ACS reports were analysed, including 478 men (mean age 65.1±11.5 years) and 236 women (mean age 69.1±11.2 years). Unstable angina pectoris (UAP) was diagnosed in 201 patients and non-ST segment elevation myocardial infarction (NSTEMI) in 489 patients. UAP and NSTEMI patients showed high rates of hypertension (88.1% and 89.6%, respectively), hyperlipoproteinemia (76.1% and 68.7%, respectively) and diabetes mellitus (36.8% and 35.2%, respectively). Complex pharmacotherapy (dual antiplatelet therapy, beta-blockers, statins, ACE inhibitors/sartans) was administered according to current recommendations. 86.5% of NSTEMI patients and 73.1% of UAP patients underwent invasive diagnostics. Interventional treatment was performed in 51.3% of NSTEMI patients and 45.3% of UAP patients. Surgical revascularization was performed in 8% of NSTE-ACS patients. Patients were transferred for invasive diagnostics in 4.8±4.0 days for men and 5.8±4.4 days for women with NSTE-ACS. There was a tendency towards less frequent revascularization in women than in men.
Conclusion: The SLOVAKS-2 2020 register results confirmed the use of complex pharmacotherapy in NSTE-ACS patients according to guidelines. Compared to previous SLOVAKS register analyses, there was an increased number of patients indicated for invasive diagnostics (and subsequent revascularization), but these patients were transferred late to the relevant cardio centre. Fig. 3, Tab. 9, Ref. 17.

Abstrakt. Úvod: Zberom a analýzou údajov o pacientoch s akútnym koronárnym syndrómom bez elevácií segmentov ST (NSTE-AKS) sa v Slovenskej republike zaoberá register SLOVAKS.
Cieľ: Zber, analýza a vyhodnotenie dát od hospitalizovaných pacientov s NSTE-AKS.
Metodika: Elektronické hlásenia od pacientov hospitalizovaných pre NSTE-AKS boli zberané počas októbra a novembra 2020. Následne boli vyhodnotené vybrané demografické a anamnestické ukazovatele, rizikový profil, diagnostický a liečebný manažment (konzervatívny a invazívny), následná revaskularizácia koronárneho riečiska. Dáta boli vyhodnotené pre celý súbor, niektoré analýzy boli vykonané aj so zameraním na diabetes mellitus a pohlavie.
Výsledky: Zo sledovaného obdobia bolo analyzovaných 714 hlásení NSTE-AKS, 478 mužov (priemerný vek 65,1 ± 11,5 rokov) a 236 žien (priemerný vek 69,1 ± 11,2 rokov). Diagnóza nestabilnej angíny pektoris (NAP) bola u 201 pacientov a infarkt myokardu bez elevácií segmentov ST (NSTEMI) u 489 chorých. U pacientov s NAP, respektíve NSTEMI bol vysoký podiel hypertenzie (88,1 %, respektíve 89,6 %), hyperlipoproteinémie (76,1 % vs. 68,7 %) a diabetes mellitus (36,8 %, respektíve 35,2 %). Komplexná farmakoterapia (duálna protidoštičková liečba, betablokátory, statíny, ACE inhibítory/sartany) bola aplikovaná podľa aktuálnych odborných odporúčaní. Invazívnu diagnostiku podstúpilo 86,5 % pacientov s NSTEMI a 73,1 % s NAP. Intervenčná liečba sa realizovala u 51,3 % v skupine NSTEMI a 45,3 % pacientov s NAP. Kardiochirurgickú revaskularizáciu podstúpilo 8 % pacientov s NSTE-AKS. Pacientov prekladali na invazívnu diagnostiku za 4,8 ± 4,0 dňa u mužov a 5,8 ± 4,4 dňa u žien s NSTE-AKS. Bol prítomný trend k menej častej revaskularizácii u žien.

Keywords: SLOVAKS register – acute coronary syndromes – UAP/NSTEMI – pharmacotherapy – invasive diagnostics / SLOVAKS – register akútnych koronárnych syndrómov NAP/NSTEMI – medikamentózna liečba – invazívna diagnostika
Published online: 21-Mar-2022
Year: 2022, Volume: 31, Issue: 1 Page From: 10, Page To: 22
doi:10.4149/Cardiol_2022_1_2
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