Clinical profile of patients with no-reperfusion therapy in Bosnia and Herzegovina and Serbia

There is little information about coronary reperfusion therapy patterns in patients with ST-elevation myocardial infarction (STEMI) in the former federal states of Yugoslavia. The objective of this study was to evaluate the clinical profile and mortality of patients who were hospitalized with a diagnosis of STEMI, but did not receive reperfusion therapy in Bosnia and Herzegovina and Serbia. This was an observational study using registry data from the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC; ClinicalTrials.gov, NCT01218776) on 633 STEMI patients admitted to 14 hospitals in Bosnia and Herzegovina (both Republic Srpska and Federation of Bosnia and Herzegovina) and Serbia from October 2012 to September 2013. Of these, 61 (9.6%) received fibrinolytic therapy (Group A), almost exclusively with streptokinase (79.3%), 402 (63.5%) underwent primary percutaneous coronary intervention (PCI; Group B), and 170 (26.9%) received no-reperfusion therapy (Group C). In Groups A, B, and C, mean age was 60.3, 60.5, and 69.1 years, respectively. Patients in Group C were more likely to present after 12 h from symptoms onset (61.3 vs. 13.6% in Group A, and 13.4% in Group B). After adjustment for risk factors and clinical presentation, female sex, age, diabetes, prior MI, and symptom onset-to-presentation time after 12 h were all independent variables associated with no-reperfusion therapy. There was a significantly reduced in-hospital mortality in patients who received reperfusion therapy with fibrinolysis or primary PCI (odds ratio: 0.27, 95% confidence interval: 0.09\u20130.76, P = 0.01). The majority of STEMI patients from Bosnia and Herzegovina and Serbia undergo reperfusion therapy with fibrinolysis or primary PCI. More than one-fourth of the patients do not received any reperfusion therapy. Reperfusion therapies are applied to relatively lower risk patients. More elderly and diabetics should be considered for such strategies

Clinical profile of patients with no-reperfusion therapy in Bosnia and Herzegovina and Serbia

There is little information about coronary reperfusion therapy patterns in patients with ST-elevation myocardial infarction (STEMI) in the former federal states of Yugoslavia. The objective of this study was to evaluate the clinical profile and mortality of patients who were hospitalized with a diagnosis of STEMI, but did not receive reperfusion therapy in Bosnia and Herzegovina and Serbia. This was an observational study using registry data from the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC; ClinicalTrials.gov, NCT01218776) on 633 STEMI patients admitted to 14 hospitals in Bosnia and Herzegovina (both Republic Srpska and Federation of Bosnia and Herzegovina) and Serbia from October 2012 to September 2013. Of these, 61 (9.6%) received fibrinolytic therapy (Group A), almost exclusively with streptokinase (79.3%), 402 (63.5%) underwent primary percutaneous coronary intervention (PCI; Group B), and 170 (26.9%) received no-reperfusion therapy (Group C). In Groups A, B, and C, mean age was 60.3, 60.5, and 69.1 years, respectively. Patients in Group C were more likely to present after 12 h from symptoms onset (61.3 vs. 13.6% in Group A, and 13.4% in Group B). After adjustment for risk factors and clinical presentation, female sex, age, diabetes, prior MI, and symptom onset-to-presentation time after 12 h were all independent variables associated with no-reperfusion therapy. There was a significantly reduced in-hospital mortality in patients who received reperfusion therapy with fibrinolysis or primary PCI (odds ratio: 0.27, 95% confidence interval: 0.09-0.76, P = 0.01). The majority of STEMI patients from Bosnia and Herzegovina and Serbia undergo reperfusion therapy with fibrinolysis or primary PCI. More than one-fourth of the patients do not received any reperfusion therapy. Reperfusion therapies are applied to relatively lower risk patients. More elderly and diabetics should be considered for such strategies. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013

Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries

Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient

Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries

WOS: 000468732700018PubMed ID: 31054483Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient.ESC - EORP; AmgenAmgen; Eli LillyEli Lilly; PfizerPfizer; SanofiSanofi-Aventis; Ferrer; Novo NordiskNovo NordiskThe EUROASPIRE V survey was carried out under the auspices of the ESC - EORP. Since the start of EORP, the following companies have supported the programme: Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk. The sponsors of the EUROASPIRE surveys had no role in the design, data collection, data analysis, data interpretation, decision to publish, or writing the manuscript

Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries

Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8\% of the patients and had been started or increased in intensity in 11.7\%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8\% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient