Predictors of 1-year outcomes in the Taiwan Acute Coronary Syndrome Full Spectrum Registry

ACS Full Spectrum Registry Investigators

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31 Citations (Scopus)

Abstract

Background/Purpose: Evidence-based guidelines have been formulated for optimal management of acute coronary syndrome (ACS). The Taiwan ACS Full Spectrum Registry aimed to evaluate the ACS management and identify the predictors of clinical outcomes of death/myocardial infarction/stroke 1year post hospital discharge. Methods: Three thousand and eighty confirmed ACS patients enrolled in this registry were followed up for 1year at 3-month intervals. Patient data on medical interventions as well as clinical events were recorded and analyzed by descriptive statistics. Results: One-year mortality among patients with ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and unstable angina was 6.1%, 10.1%, and 6.2%, respectively. Use of secondary preventive therapies was suboptimal throughout the follow-up phase, especially dual antiplatelet therapy, which fell from 74.8% patients at discharge to 24.9% patients at 1-year follow-up. The odds of an adverse incidence of death/myocardial infarction/stroke 1year after discharge was significantly reduced in patients receiving aspirin and clopidogrel for ≥9months and was consequently higher in patients in whom dual antiplatelet therapy was discontinued or prescribed for <9months. Chronic renal failure, in-hospital bleeding, a diagnosis of NSTEMI, and antiplatelet therapy discontinuation had a negative association with 1-year outcomes, whereas the use of drug-eluting stents and antiplatelet agents, clopidogrel and aspirin, were predictors of positive outcomes. Conclusion: There is a significant deviation from evidence-based guidelines in ACS management in Taiwan as reported in other countries. Policy adherence, especially with regard to dual antiplatelet therapy may hold the key to long-term favorable outcomes and improved survival rates in ACS patients in Taiwan.

Original languageEnglish
Pages (from-to)794-802
Number of pages9
JournalJournal of the Formosan Medical Association
Volume113
Issue number11
DOIs
Publication statusPublished - 2014 Nov 1

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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