Contemporary antithrombotic strategies in patients with acute coronary syndrome admitted to cardiac care units in Italy: The EYESHOT Study

被引：92

作者：

De Luca, Leonardo ^{[1
]}

Leonardi, Sergio ^{[2
]}

Cavallini, Claudio ^{[3
]}

Lucci, Donata ^{[4
]}

Musumeci, Giuseppe ^{[5
]}

Caporale, Roberto ^{[6
]}

Abrignani, Maurizio G. ^{[7
]}

Lupi, Alessandro ^{[8
]}

Rakar, Serena ^{[9
]}

Gulizia, Michele M. ^{[10
]}

Bovenzi, Francesco M. ^{[11
]}

De Servi, Stefano ^{[2
]}

De Luca, L.

De Servi, S.

Caporale, R.

Cavallini, C.

Ceravolo, R.

Formigli, D.

Leonardi, S.

Lupi, A.

Musumeci, G. ^{[44
]}

Rakar, S. ^{[39
]}

Smecca, I. M. ^{[38
]}

Maggioni, A. P. ^{[12
]}

Lucci, D. ^{[12
]}

Lorimer, A. ^{[12
]}

Orsini, G. ^{[12
]}

Gonzini, L. ^{[12
]}

Fabbri, G. ^{[12
]}

Bianchini, E. ^{[12
]}

Abrignani, M. G. ^{[13
]}

Bonura, F. ^{[13
]}

Trimarco, B. ^{[14
]}

Galasso, G. ^{[14
]}

Misuraca, G.

Manes, M. T.

Tuccillo, B. ^{[15
]}

Irace, L. ^{[15
]}

Olivari, Z.

Totis, O.

Ledda, A.

Mauro, C. ^{[16
]}

Boccalatte, M. ^{[16
]}

Iliceto, S. ^{[17
]}

Cacciavillani, L. ^{[17
]}

Savonitto, S. ^{[18
]}

Tortorella, G. ^{[18
]}

Esposito, L.

De Rosa, P.

Calabro, P. ^{[19
]}

机构：

[1] European Hosp, Dept Cardiovasc Sci, Via Portuense 700, Rome, Italy

[2] Fdn IRCCS Policlin San Matteo, Div Cardiol, Pavia, Italy

[3] Santa Maria della Misericordia Hosp, Div Cardiol, Pavia, Italy

[4] ANMCO Res Ctr, Florence, Italy

[5] AO Papa Giovanni XXIII, Cardiovasc Dept, Bergamo, Italy

[6] Osped Civile Annunziata, Div Intervent Cardiol, Bergamo, Italy

[7] S Antonio Abate Hosp, Div Cardiol, Milan, Italy

[8] Maggiore Carita Hosp, Div Cardiol, Novara, Italy

[9] Cattinara Hosp, Div Cardiol, Trieste, Italy

[10] Garibaldi Nesima Hosp, Div Cardiol, Catania, Italy

[11] Campo Marte Hosp, Cardiol Div, Lucca, Italy

[12] ANMCO Res Ctr, Florence, Italy

[13] Erice, Trapani, Italy

[14] AOU Fed II, Naples, Italy

[15] Osp Loreto Mare, Naples, Italy

[16] AORN Cardarelli, Naples, Italy

[17] AO Padova, Padua, Italy

[18] Arcispedale SM Nuova, Reggio Emilia, Italy

[19] AORN Osp Colli, Cardiol SUN, Naples, Italy

[20] Osp G Mazzini, Teramo, Italy

[21] Osp Maggiore, Bologna, Italy

[22] AORN Osp Colli, UOC Cardiol, Naples, Italy

[23] IRCCS Policlin S Matteo, Pavia, Italy

[24] IRCCS San Martino, Genoa, Italy

[25] Osp Maggiore Policlin, Milan, Italy

[26] AO S Giovanni Addolorata, Rome, Italy

[27] Policlin Casilino, Rome, Italy

[28] Spedali Civil Brescia, Brescia, Italy

[29] Osp Riuniti G Melacrino F Bianchi, Reggio Di Calabria, Italy

[30] Osp Riuniti, Foggia, Italy

[31] AO G Brotzu, Cagliari, Italy

[32] Ctr Cardiol Monzino, Milan, Italy

[33] Osp Madre G Vannini, Rome, Italy

[34] FTGM, Massa, Italy

[35] Osp San Gerardo, Monza, Italy

[36] Osp Giovanni Bosco, Turin, Italy

[37] Osp San Paolo, Bari, Italy

[38] ARNAS PO Civico & Benfratelli, Palermo, Italy

[39] AOU Osp Riuniti, Trieste, Italy

[40] Osp San Giovanni Dio, Cagliari, Italy

[41] Osp Vito Fazzi, Lecce, Italy

[42] Osp San Camillo, Rome, Italy

[43] Aurelia Hosp, Rome, Italy

[44] Fdn Poliambulanza, Brescia, Italy

[45] Osp San Paolo, Milan, Italy

[46] Osp San Pietro FBF, Rome, Italy

[47] Osp Sant Andrea Roma, Rome, Italy

[48] Osp SS Annunziata, Taranto, Italy

[49] Osp Niguarda, Milan, Italy

[50] Osp Sandro Pertini, Rome, Italy

来源：

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE | 2015年 / 4卷 / 05期

关键词：

Acute coronary syndrome; antithrombotic therapy; prasugrel; ticagrelor; heparins; bivalirudin;

D O I：

10.1177/2048872614560505

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Several new antithrombotic therapies have emerged for the treatment of acute coronary syndrome (ACS). We sought to assess contemporary patterns of antithrombotic therapies use in patients with ACS. Methods and results: EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in patients admitted to intensive cardiac care units (CCUs) for an ACS in Italy. Over a three-week period, 203 CCUs enrolled 2585 consecutive patients: 41.2% with ST-elevation myocardial infarction (STEMI) and 58.8% with non-ST elevation ACS (NSTE-ACS). During hospitalisation, low-molecular-weight heparins, aspirin, and clopidogrel were the most commonly used antithrombotic therapies. Among patients treated with percutaneous coronary intervention (PCI, n=1755), any crossover of heparin therapy occurred in 30.8% of cases, while switching from one P2Y(12) inhibitor to another occurred in 3.6% of cases in the CathLab and in 14.2% before discharge. Of the 790 patients who did not receive revascularisation, switching of a P2Y(12) inhibitor occurred in 5.7% of cases. At discharge, a new P2Y(12) inhibitor (ticagrelor or prasugrel) in association with aspirin was prescribed in 59.5% of STEMI and 33.9% of NSTE-ACS patients: the most powerful predictor for prescription was PCI (odds ratio (OR) 6.18; 95% confidence interval (CI) 4.76-8.01; p<0.0001), whereas age >= 75 years was strongly associated with clopidogrel use (OR 0.28; 95% CI 0.22-0.36; p<0.0001). Conclusions: The EYESHOT registry shows the current pattern of antithrombotic treatments for ACS patients admitted to Italian CCUs and provides insights which may help to improve the clinical care of such patients.

引用

页码：441 / 452

页数：12

共 22 条

[1] Evaluating the Performance of the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines (CRUSADE) Bleeding Score in a Contemporary Spanish Cohort of Patients With Non-ST-Segment Elevation Acute Myocardial Infarction [J].

Abu-Assi, Emad ;

Maria Gracia-Acuna, Jose ;

Ferreira-Gonzalez, Ignacio ;

Pena-Gil, Carlos ;

Gayoso-Diz, Pilar ;

Ramon Gonzalez-Juanatey, Jose .

CIRCULATION, 2010, 121 (22) :2419-U100

[2] Management and outcomes of patients presenting with STEMI by use of chronic oral anticoagulation: results from the GRACE registry [J].

Alonso, Alvaro ;

Gore, Joel M. ;

Awad, Hamza H. ;

Quill, Ann L. ;

Montalescot, Gilles ;

van de Werf, Frans ;

Gulba, Dietrich C. ;

Fox, Keith A. A. ;

Eagle, Kim A. ;

Granger, Christopher B. ;

Wyman, Allison ;

Steg, Ph Gabriel .

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, 2013, 2 (03) :280-291

[3] 2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction [J].

Anderson, Jeffrey L. ;

Adams, Cynthia D. ;

Antman, Elliott M. ;

Bridges, Charles R. ;

Califf, Robert M. ;

Casey, Donald E., Jr. ;

Chavey, William E. ;

Fesmire, Francis M. ;

Hochman, Judith S. ;

Levin, Thomas N. ;

Lincoff, A. Michael ;

Peterson, Eric D. ;

Theroux, Pierre ;

Wenger, Nanette Kass ;

Wright, R. Scott ;

Anderson, Jeffrey L. ;

Adams, Cynthia D. ;

Bridges, Charles R. ;

Casey, Donald E., Jr. ;

Ettinger, Steven M. ;

Fesmire, Francis M. ;

Ganiats, Theodore G. ;

Jneid, Hani ;

Lincoff, A. Michael ;

Peterson, Eric D. ;

Philippides, George J. ;

Theroux, Pierre ;

Wenger, Nanette K. ;

Zidar, James Patrick ;

Jacobs, Alice K. ;

Anderson, Jeffrey L. ;

Albert, Nancy ;

Hochman, Judith S. ;

Creager, Mark A. ;

Kushner, Frederick G. ;

Ettinger, Steven M. ;

Ohman, Erik Magnus ;

Guyton, Robert A. ;

Stevenson, William G. ;

Halperin, Jonathan L. ;

Yancy, Clyde W. .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 57 (19) :E215-E367

[4] Epidemiology of acute myocardial infarction in the Italian CCU network - The BLITZ Study [J].

Di Chiara, A ;

Chiarella, F ;

Savonitto, S ;

Lucci, D ;

Bolognese, L ;

De Servi, S ;

Greco, C ;

Boccanelli, A ;

Zonzin, P ;

Coccolini, S ;

Maggioni, AP .

EUROPEAN HEART JOURNAL, 2003, 24 (18) :1616-1629

[5] A validated prediction model for all forms of acute coronary syndrome - Estimating the risk of 6-month postdischarge death in an international registry [J].

Eagle, KA ;

Lim, MJ ;

Dabbous, OH ;

Pieper, KS ;

Goldberg, RJ ;

Van de Werf, F ;

Goodman, SG ;

Granger, CB ;

Steg, PG ;

Gore, JM ;

Budaj, A ;

Avezum, A ;

Flather, MD ;

Fox, KAA .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (22) :2727-2733

[6] The expanded Global Registry of Acute Coronary Events: Baseline characteristics, management practices, and hospital outcomes of patients with acute coronary syndromes [J].

Goodman, Shaun G. ;

Huang, Wei ;

Yan, Andrew T. ;

Budaj, Andrzej ;

Kennelly, Brian M. ;

Gore, Joel M. ;

Fox, Keith A. A. ;

Goldberg, Robert J. ;

Anderson, Frederick A. .

AMERICAN HEART JOURNAL, 2009, 158 (02) :193-201E5

[7] Use of heparins in non-ST-elevation acute coronary syndromes [J].

Gore, Joel M. ;

Spencer, Frederick A. ;

Goldberg, Robert J. ;

Kennelly, Brian M. ;

Fox, Keith A. A. ;

Allegrone, Jeanna ;

Eagle, Kim A. ;

Anderson, Frederick A., Jr. ;

Steg, Philippe G. .

AMERICAN JOURNAL OF MEDICINE, 2007, 120 (01) :63-71

[8] ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation [J].

Hamm, Christian W. ;

Bassand, Jean-Pierre ;

Agewall, Stefan ;

Bax, Jeroen ;

Boersma, Eric ;

Bueno, Hector ;

Caso, Pio ;

Dudek, Dariusz ;

Gielen, Stephan ;

Huber, Kurt ;

Ohman, Magnus ;

Petrie, Mark C. ;

Sonntag, Frank ;

Uva, Miguel Sousa ;

Storey, Robert F. ;

Wijns, William ;

Zahger, Doron .

EUROPEAN HEART JOURNAL, 2011, 32 (23) :2999-3054

[9] Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes Undergoing Coronary Artery Bypass Surgery Results From the PLATO (Platelet Inhibition and Patient Outcomes) Trial [J].

Held, Claes ;

Asenblad, Nils ;

Bassand, Jean Pierre ;

Becker, Richard C. ;

Cannon, Christopher P. ;

Claeys, Marc J. ;

Harrington, Robert A. ;

Horrow, Jay ;

Husted, Steen ;

James, Stefan K. ;

Mahaffey, Kenneth W. ;

Nicolau, Jose C. ;

Scirica, Benjamin M. ;

Storey, Robert F. ;

Vintila, Marius ;

Ycas, Joseph ;

Wallentin, Lars .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 57 (06) :672-684

[10] Ticagrelor Versus Clopidogrel in Elderly Patients With Acute Coronary Syndromes A Substudy From the Prospective Randomized PLATelet Inhibition and Patient Outcomes (PLATO) Trial [J].

Husted, Steen ;

James, Stefan ;

Becker, Richard C. ;

Horrow, Jay ;

Katus, Hugo ;

Storey, Robert F. ;

Cannon, Christopher P. ;

Heras, Magda ;

Lopes, Renato D. ;

Morais, Joao ;

Mahaffey, Kenneth W. ;

Bach, Richard G. ;

Wojdyla, Daniel ;

Wallentin, Lars .

CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2012, 5 (05) :680-688

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