Global patterns of use of antithrombotic and antiplatelet therapies in patients with acute coronary syndromes: insights from the Global Registry of Acute Coronary Events (GRACE)
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Authors
Budaj, AndrzejBrieger, David
Steg, Phillippe Gabriel
Goodman, Shaun G.
Dabbous, Omar H.
Fox, Keith A. A.
Avezum, Alvaro
Cannon, Christopher P.
Mazurek, Tomasz
Flather, Marcus D.
Van de Werf, Frans
GRACE Investigators
UMass Chan Affiliations
Center for Outcomes ResearchDocument Type
Journal ArticlePublication Date
2003-12-09Keywords
Acute DiseaseAged
Angioplasty, Balloon, Coronary
Biological Markers
Coronary Thrombosis
Female
Fibrinolytic Agents
Heparin
Heparin, Low-Molecular-Weight
Hospitalization
Humans
Male
Middle Aged
Multivariate Analysis
Platelet Aggregation Inhibitors
Registries
Regression Analysis
Statistics, Nonparametric
Syndrome
Troponin
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: Many agents are available to treat acute coronary syndromes (ACS), yet limited information is available about their use from a multinational perspective. The objective of this report was to describe patterns of use of antithrombotic and antiplatelet therapies in patients with the spectrum of ACS through the use of data from the Global Registry of Acute Coronary Events (GRACE). METHODS: Data from 12,665 patients with ACS were analyzed. Baseline characteristics, clinical presentation, and medication use were compared. Regional differences in the administration of antiplatelet and antithrombotic therapies were analyzed. Multivariable logistic regression was implemented to determine independent variables indicating the use of various hospital therapies. RESULTS: Overall, unfractionated heparin was used in 57% of patients and low-molecular-weight heparin in 47% (P <.0001). More than 90% of patients received aspirin, but approximately 13% were not discharged on aspirin. Overall, 30% of patients received thienopyridines (with percutaneous coronary intervention [PCI] in 79%). Of those who did not receive aspirin, 31% received thienopyridines. Intravenous glycoprotein inhibitors were given to 17% of patients. Among those treated with PCI, only 47% received glycoprotein inhibitors, and 21% of those given glycoprotein inhibitors did not undergo PCI. Significant geographic variation was apparent in the use of unfractionated heparin, low-molecular-weight heparin, thienopyridines, and glycoprotein inhibitors. CONCLUSIONS: Despite the availability of guidelines, striking geographic and practice variations are apparent in the use of antithrombotic and antiplatelet therapies. There remains significant room for improvement in the use of these therapies in patients with ACS, which should lead to improvement in care and outcomes.Source
Am Heart J. 2003 Dec;146(6):999-1006. Link to article on publisher's siteDOI
10.1016/S0002-8703(03)00509-XPermanent Link to this Item
http://hdl.handle.net/20.500.14038/27260PubMed ID
14660991Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/S0002-8703(03)00509-X