The expanded Global Registry of Acute Coronary Events: Baseline characteristics, management practices, and hospital outcomes of patients with acute coronary syndromes
dc.contributor.author | Goodman, Shaun G. | |
dc.contributor.author | Huang, Wei | |
dc.contributor.author | Yan, Andrew T. | |
dc.contributor.author | Budaj, Andrzej | |
dc.contributor.author | Kennelly, Brian M. | |
dc.contributor.author | Gore, Joel M. | |
dc.contributor.author | Fox, Keith A. A. | |
dc.contributor.author | Goldberg, Robert J. | |
dc.contributor.author | Anderson, Frederick A. | |
dc.contributor.author | Expanded Global Registry of Acute Coronary Events (GRACE2) Investigators | |
dc.date | 2022-08-11T08:08:38.000 | |
dc.date.accessioned | 2022-08-23T16:01:42Z | |
dc.date.available | 2022-08-23T16:01:42Z | |
dc.date.issued | 2009-08-22 | |
dc.date.submitted | 2009-08-07 | |
dc.identifier.issn | 1097-6744 (Electronic) | |
dc.identifier.pmid | 19619694 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/31191 | |
dc.description.abstract | BACKGROUND: The Global Registry of Acute Coronary Events (GRACE)-a prospective, multinational study of patients hospitalized with acute coronary syndromes (ACSs)-was designed to improve the quality of care for patients with an ACS. Expanded GRACE aims to test the feasibility of a simplified data collection tool and provision of quarterly feedback to index individual hospital management practices to an international reference cohort. METHODS: We describe the objectives; study design; study and data management; and the characteristics, management, and hospital outcomes of patients > or =18 years old enrolled with a presumptive diagnosis of ACS. RESULTS: From 2001 to 2007, 31,982 patients were enrolled at 184 hospitals in 25 countries; 30% were diagnosed with ST-segment elevation myocardial infarction, 31% with non-ST-segment myocardial infarction, 26% with unstable angina, and 12% with another cardiac/noncardiac final diagnosis. The median age was 65 (interquartile range 55-75) years; 24% were >75 years old, and 33% were women. In general, increases were observed over time across the spectrum of ACS (1) in the use in the first 24 hours and at discharge of aspirin, clopidogrel, beta-blockers, and angiotensin-converting enzyme inhibitors/receptor blockers; (2) in the use at discharge of statins; (3) in the early use of glycoprotein IIb/IIIa inhibitors and low-molecular-weight heparin; and (4) in the use of cardiac catheterization and percutaneous coronary intervention. An increase in the use of primary percutaneous coronary intervention and a similar decrease in the use of fibrinolysis in ST-segment elevation myocardial infarction were also seen. CONCLUSIONS: Over the course of 7 years, general increases in the use of evidence-based therapies for ACS patients were observed in the expanded GRACE. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=19619694&dopt=Abstract">Link to Article in PubMed</a> | |
dc.relation.url | http://dx.doi.org/10.1016/j.ahj.2009.06.003 | |
dc.rights | Citation: Am Heart J. 2009 Aug;158(2):193-201.e1-5. <a href="http://dx.doi.org/10.1016/j.ahj.2009.06.003">Link to article on publisher's site</a> | |
dc.subject | Acute Coronary Syndrome | |
dc.subject | Quality of Health Care | |
dc.subject | Evidence-Based Medicine | |
dc.subject | Cardiovascular Diseases | |
dc.subject | Health Services Research | |
dc.title | The expanded Global Registry of Acute Coronary Events: Baseline characteristics, management practices, and hospital outcomes of patients with acute coronary syndromes | |
dc.type | Journal Article | |
dc.source.journaltitle | American heart journal | |
dc.source.volume | 158 | |
dc.source.issue | 2 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/gsbs_cphr/23 | |
dc.identifier.contextkey | 928571 | |
html.description.abstract | <p>BACKGROUND: The Global Registry of Acute Coronary Events (GRACE)-a prospective, multinational study of patients hospitalized with acute coronary syndromes (ACSs)-was designed to improve the quality of care for patients with an ACS. Expanded GRACE aims to test the feasibility of a simplified data collection tool and provision of quarterly feedback to index individual hospital management practices to an international reference cohort.</p> <p>METHODS: We describe the objectives; study design; study and data management; and the characteristics, management, and hospital outcomes of patients > or =18 years old enrolled with a presumptive diagnosis of ACS.</p> <p>RESULTS: From 2001 to 2007, 31,982 patients were enrolled at 184 hospitals in 25 countries; 30% were diagnosed with ST-segment elevation myocardial infarction, 31% with non-ST-segment myocardial infarction, 26% with unstable angina, and 12% with another cardiac/noncardiac final diagnosis. The median age was 65 (interquartile range 55-75) years; 24% were >75 years old, and 33% were women. In general, increases were observed over time across the spectrum of ACS (1) in the use in the first 24 hours and at discharge of aspirin, clopidogrel, beta-blockers, and angiotensin-converting enzyme inhibitors/receptor blockers; (2) in the use at discharge of statins; (3) in the early use of glycoprotein IIb/IIIa inhibitors and low-molecular-weight heparin; and (4) in the use of cardiac catheterization and percutaneous coronary intervention. An increase in the use of primary percutaneous coronary intervention and a similar decrease in the use of fibrinolysis in ST-segment elevation myocardial infarction were also seen.</p> <p>CONCLUSIONS: Over the course of 7 years, general increases in the use of evidence-based therapies for ACS patients were observed in the expanded GRACE.</p> | |
dc.identifier.submissionpath | gsbs_cphr/23 | |
dc.contributor.department | Department of Medicine, Division of Cardiovascular Medicine | |
dc.contributor.department | Center for Outcomes Research | |
dc.source.pages | 193-201.e1-5 | |
dc.contributor.student | Wei Huang |