secondary prevention of a recurrent acs; results from the 2004 & 2006 acsis survey perl l, behar...
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Methods Data was collected from the 2004 and 2006 ACSIS (Acute Coronary Syndrome Israeli Survey) - a biannual survey on acute myocardial infarction performed in 26 intensive cardiac care units in Israel during a two-month period. In the two surveys, there were 1207 RACS out of 4168 patients over all.TRANSCRIPT
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Secondary prevention of a Recurrent ACS; Results from the 2004 & 2006 ACSIS Survey
Perl L, Behar S, Schwartz R, Mosseri M
Meir Hospital and Sheba Tel Hashomer, Sackler Meir Hospital and Sheba Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv UniversityFaculty of Medicine, Tel Aviv University
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IntroductionIntroduction The preventive effects of cardiovascular drugs
after an acute coronary syndrome (ACS) are well established, but little is known concerning the characteristics of a recurrent event, if one should occur.
We therefore studied the characteristics of an ACS in patients who present with a recurrent ACS (RACS), and the association with secondary preventive drugs.
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MethodsMethodsData was collected from the 2004 and
2006 ACSIS (Acute Coronary Syndrome Israeli Survey) - a biannual survey on acute myocardial infarction performed in 26 intensive cardiac care units in Israel during a two-month period.
In the two surveys, there were 1207 RACS out of 4168 patients over all.
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Secondary treatment surveyed: ACEi, beta blockers, statins, platelet inhibitors.
Data were analysed and was assessed for survival according to secondary treatment rates according to the following variables:Recurrent vs. first ACS, KILLIP and TIMI risk scores, and other variables.
Methods 2Methods 2
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Patients’ CharacteristicsPatients’ Characteristics
KILLIPTIMIFACS Age
FemaleMaleGender
% of TotalNumberVariableCategory
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Results (I)- Results (I)- Treatment RatesTreatment Rates
Treatment Rate
0%20%
40%60%
80%
01-23-4Num. of Drugs
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Results (II)-Results (II)- Mortality according Mortality according to number of drugsto number of drugs
Mortality
0%2%4%6%8%
01-23-4Num. of Drugs
7d Mortality
30d Mortality
P=NS
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Results (III)- Results (III)- 11 Year Mortality Year Mortality??????????
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Results (III)Results (III) However, when corrected for TIMI scores, there However, when corrected for TIMI scores, there
is a trend towards lower mortality in the 3-4 is a trend towards lower mortality in the 3-4 drugs (OR=0.88, CI 0.49-1.61 in the high TIMI drugs (OR=0.88, CI 0.49-1.61 in the high TIMI score).score).
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ConclusionsConclusionsIn general, RACS patients are under
treated with secondary preventive drugs prior to admission.
Although initial analysis revealed a trend for a higher short term mortality rate in those who were treated with more drugs, there was no change in mortality when adjusted for confounding factors.
After a year….????