SIX-MONTH OUTCOMES IN ACUTE CORONARY SYNDROME PATIENTS INCLUDED IN THE REGISTRY RECORD-3

Erlikh A. D. on behalf of the RECORD-3* working team

Aim. Evaluation of 6-month observation of acute coronary syndrome (ACS) patients included into the ACS registry RECORD-3.

Material and methods. To the registry RECORD-3, all ACS patients were being included if hospitalized during 1 month in 2015 (march-april) in 47 centers among 37 Russia cities. Follow-up lasted for 6 months with telephone calls, in 35 centers.

Results. Among all participants (n=2370), 6-month outcomes were collected in 1433 (64%). By most demographic, anamestic and clinical characteristics the group of those failed to collect data was comparable with the others. Frequency of fatal outcomes after discharge in 6 months post ACS was 4,2%, new myocardial infarction (MI) — 3,2%, stroke — 0,7%. Frequency of combination events (death+MI), death+ MI+stroke reached 5,7% and 8,5%, respectively. Coronary intervention in 6 months was done in 12,0% (2/3 underwent PCI, 1/3 — bypass surgery). In 19% cases the intervention was urgent. There were no statistically significant differences by the prevalence of adverse events and bypass surgery among those with diagnosed MI in-patient and non-MI, as between ACS with ST elevation (STEACS) or no (NSTEACS), excluding the prevalence of fatal outcomes: 2,8% in STEACS and 5,0% in NSTEACS (p=0,038). The grade of frequency decline of prescribed medication intake by 6 months reached 12% for aspirin, 29% for clopidogrel, 33% for ticagrelor, 29% for oral anticoagulants, 28 for ACEi/ARB, 19% for beta-blockers, 21% for statins.

Conclusion. By multifactorial regression analysis, the independent predictors of fatal outcomes were found, that developed in 6 months post discharge.

1. Bhatt DL, Eagle K, Ohman M, et al. Comparative determinants of 4-years cardiovascular event rates in stable outpatients at risk of or with atherothrombosis. JAMA, 2010; 304 (12): 1350-57.

2. Nacatani D, Sakata Y, Usami M, et al. Incidence, predictors and subsequent mortality risk of recurrent myocardial infarction in patients following discharge for acute myocardial infarction. Circ J, 2013; 77 (2): 439-46.

3. Eagle KA, Lim MJ, Dabbous OH, et al. A validated prediction model for all forms of acute coronary syndrome. Estimating the risk of 6-month postdischarge death in an international registry. JAMA. 2004; 291 (22): 2727-33.

4. Heart Disease and stroke statistic — 2011 update. A report from American Heart Association. Circulation. 2013; 127: e6-e245.

5. Erlikh AD, Gratsiansky NA. RECORD-3. Kardiologiia, 2016; 4: 16-24. (In Russ.) Эрлих А. Д., Грацианский Н.А. от имени участников регистра РЕКОРД-3. Кардиология. 2016; 4: 16-24.

6. Boytsov SA, Martsevich SYu, Kutishenko NP, et al. Registries in cardiology: their principles, rules and real-world potential. Cardiovascular Therapy and Prevention, 2013; 12 (1): 4-9. (In Russ.) Бойцов С.А., Марцевич С.Ю, Кутишенко Н.П., и др. Регистры в кардиологии. Основные правила проведения и реальные возможности. Кардиоваскулярная терапия и профилактика, 2013; 12 (1): 4-9. DOI:10.15829/1728-8800-2013-1-4-9

7. Ho PM, Spetrus JA, Masoudi FA, et al. Impact of medication therapy discontinuation on mortality after myocardial infarction. Arch Intern Med. 2006 Sep 25; 166 (17): 1842-7.

8. Rasmussen JN, Chong A, Alter DA. Relationship between adherence to evidence-based pharmacotherapy and long-term mortality after acute myocardial infarction. JAMA. 2007 Jan 10; 29 (2): 177-86.

9. Erlikh AD, Gratsiansky NA, on behalf of RECORD registry participants. Six-month results of the Russian independent registry of acute coronary syndromes RECORD. Kardiologiia. 2011; 12: 11-6. (In Russ.) Эрлих А. Д., Грацианский Н.А. от имени участников регистра РЕКОРД. Результаты шестимесячного наблюдения за больными с острыми коронарными синдромами в Российском регистре РЕКОРД. Кардиология. 2011; 12: 11-6. 10. Goldberg RJ, Currie K, White K, et al. Six-month outcomes in a multinational registry of patients hospitalized with an acute coronary syndrome (the Global Registry of Acute Coronary Events [GRACE]). Am J Cardiol. 2004 Feb 1; 93 (3): 288-93.

10. Lin A, Devlin G, Lee M, Kerr AJ. Performance of the GRACE score in a New Zeland acute coronary syndrome cohort. Heart. 2014 Dec; 100 (24): 1960-6.

11. Barrabes JA, Jimenez-Candil J, del Nogal Saez F, et al. Prognosis and management of acute coronary syndrome in Spain in 2012: the DIOCLEX study. Rev Esp Cardiol. 2015; 68: 98-106.

12. Mehran R, Baber U, Steg PG, et al. Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study. Lancet. 2013 Nov 23; 382 (9906): 1714-22.