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    [Treatment of the acute coronary syndrome in Germany: experiences in a German cluster of the GRACE registry]

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    Authors
    Tebbe, U.
    Bramlage, P.
    von Lows of Menar, P.
    Lawall, H.
    Gaudron, P.
    Luders, S.
    Klaus, A.
    Lengfelder, W.
    Scholz, K. H.
    Maziewjewski, S.
    Cuneo, A.
    Hohmann, V.
    Gulba, Dietrich C.
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    UMass Chan Affiliations
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2007-09-21
    Keywords
    Acute Disease; Adrenergic Antagonists; Aged; Angina, Unstable; Angioplasty, Balloon, Coronary; Angiotensin-Converting Enzyme Inhibitors; Anti-Arrhythmia Agents; Anticholesteremic Agents; Anticoagulants; Calcium Channel Blockers; Cardiotonic Agents; Cluster Analysis; Coronary Artery Bypass; Coronary Disease; Female; Germany; Humans; Male; Middle Aged; Myocardial Infarction; Platelet Aggregation Inhibitors; Prognosis; Registries; Thrombolytic Therapy
    Health Services Research
    
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    Link to Full Text
    http://dx.doi.org/10.1055/s-2007-985631
    Abstract
    BACKGROUND: The acute coronary syndrome (ACS) remains a major cause of mortality and morbidity in the western world. The Global Registry of Acute Coronary Events (GRACE) documents inpatients with all types of ACS and a follow-up at three months in Germany and worldwide. METHODS: The data of the German Cluster Detmold were compared with data from the worldwide GRACE registry (31,070 patients). Data from 849 patients with ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) were collected from October 2001 to September 2005 in eight participating hospitals in the GRACE2 Cluster Detmold. RESULTS: Compared with the worldwide GRACE data the patients in the Cluster Detmold had longer pre-hospital admission times (STEMI patients < 1 h: 13.9 % vs. 17.0 %; p < 0.05); more frequent interventions (PCI 60.1 % vs. 48.7%; p < 0.001) and less thrombolysis (17.9 vs. 42.5%; p < 0.001) in STEMI patients; more frequent use of platelet inhibitors (clopidogrel and ticlopidine, 93.4 % vs. 89.4%; p < 0.001) and unfractionated heparin (69.8 % vs. 36.5; p < 0.001), and less frequent use of low molecular weight heparin (31.1 % vs. 51.2%; p < 0.001); more frequent use of RAS blocking agents (80.2 vs. 66.6, p < 0.001) and beta blockers (87.4 vs. 78.8, p < 0.001) and less frequent use of lipid lowering agents (23.5 vs. 72.5%; p < 0.001). CONCLUSIONS: Current management of ACS in Germany closely follows the recommendations of the German society of Cardiology. Differences in practice may account for the observed substantially lower event rates in Germany during hospitalization, but there is still room for improvement in the pre-hospital phase und in the degree to which pharmacotherapy is used for secondary prevention.
    Source
    Dtsch Med Wochenschr. 2007 Sep;132(39):2000-5. Link to article on publisher's site
    DOI
    10.1055/s-2007-985631
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27287
    PubMed ID
    17882737
    Notes

    Article is in German with an abstract in English.

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    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1055/s-2007-985631
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