Registry of Acute Coronary Syndromes "RECORD-3". Characteristics of Patients and Treatment During Initial Hospitalization
Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. Material and methods. RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n = 47, 55% «invasive») during 1 month. Results. Number of included pts was 2370 (39% women, mean age 64.6 years), 72% were admitted to invasive hospitals, 37% had ST-elevation ACS (STEACS). Median «onset of symptoms - first medical contact» time was 3.4 (1.0-16.8) hours, «first medical contact - hospital admission» time - 1.5 (1.0-3.1) hours. Cardiac troponin was determined in 76% of pts. Coronary angiography was carried out in 70 and 46% of pts with STE and non-STE ACS, respectively. (16% of all patients hospitalized in «noninvasive» cetnters were transferred for angiography to invasive ones). Primary percutaneous coronary intervention (PCI) was performed in 39% of patients with STEACS (in 65% of them with «door to pPCI» time <90 min). Thrombolytic therapy (TLT) was administered to 32% of pts (in half of them prehospitally). Overall reperfusion therapy received 68% of pts. Among non-STEACS pts rate of PCI was 20% (1/3 of procedures within 2, 1/3 - > 2-24 hours). Inhospital antiplatelet therapy (APT) included aspirin (88%), clopidogrel (71%), ticagrelor (14%); 86% of pts received dual APT. Other medications were: unfractionated heparin (UFH, 47% [81% subcutaneously]), enoxaparin (13%), fondaparinux (10%), angiotensin converting enzyme inhibitors/sartans (81%), ß-adrenoblockers (84%), statins (87%). Mortality during hospitalization (median 10 days) was 10% in STE, and 5% in non-STE ACS. Conclusion. Inhospital management of RECORD-3 population was characterized by relatively low rates of pPCI, reperfusion therapy in STEACS, urgent PCI in non-STEACS. Preponderance of UFG including its subcutaneous use is of note. Use of other standard therapies appears satisfactory.