CARDIOVASCULAR RISK IN PATIENTS WHO ARRIVE AT THE EMERGENCY ROOM WITH ACUTE CORONARY SYNDROME: PP.2.70

Abstract

Objectives: To study whether there are therapeutic or clinical differences between patients with a first acute coronary syndrome and those with a second coronary event, and to evaluate differences between the two groups at admission and discharge. Methods: An epidemiological, observational, cross-sectional and single-center study was carried out in the emergency medicine department of a university hospital. Over 6 consecutive months we assessed outpatients of both sexes and 18 yrs or older who came to the emergency room because of an acute vascular event as defined by the criteria of the American heart Association. Demographic, clinical (diabetes mellitus, hypertension, atrial fibrillation, dyslipidemia, smoking, type of heart disease, peripheral vascular disease) and therapeutic variables were collected. Results: First acute coronary syndrome: We observed differences at admission and discharge, specifically in the percentage of patients receiving antiplatelet treatment (23.3% vs. 92.9%) and statins (35.7% vs 85.7%). This association was not statistically significant, probably due to the sample size. Second Acute Coronary Syndrome: 60% were on statin therapy and 88% on antiplatelets. There were no statistically significant differences between treatment with statins (60% vs 96%) or with antiplatelets (88% vs 92%) at admission and discharge. There were no deaths during hospitalization. The number of patients receiving statin therapy at admission for a second coronary event was higher than for patients with a first event(60% vs. 20%, p 0.05). The same trend was observed for antiplatelet treatment (88% vs. 23.3%, p 0.01). There were no statistically significant differences regarding treatment at discharge. Diabetes and peripheral vasculopathy were significantly related to a second acute coronary event (p < 0.01). Conclusions: We observed an active attitude in the treatment of cardiovascular risk factors at discharge with respect to admission in patients presenting a first acute coronary syndrome. Secondary prevention has been suboptimal in patients with a second event.