TWELVE MONTHS OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROME, BY THE NATIONAL REGISTRY RECORD-3

Abstract

Aim. In the article, the analysis of the Russian independent registry presented on acute coronary syndrome (ACS) — RECORD-3, aimed for evaluation of adverse outcomes rate by 12 months after ACS, as the long term management of ACS patients. Material and methods. To analysis, 966 patients included (43% of all discharged). By most anamnesitcal and clinical data, as by management specifics, patients groups that were and those that were not assessed for 12 month outcomes, did not differ significantly. Results. The rate of fatal outcomes developed post discharge during 12 months after ACS, was 8,4% (4,8% in ACS with ST elevation (STEACS) and 10,5% in ACS non-ST elevation (NSTEACS); р=0,0012), summated events death+myocardial infarction (MI) + stroke was 12,8% (8,4% in STEACS and 15,4% in NSTEACS; р=0,0012). Mortality in 12 months from the onset of ACS was 15,8% (18,3% in STEACS and 14,2% in NSTEACS; р=0,077), summated events death+MI+stroke in 12 months from the onset of ACS was 19,9% (21,4% in STEACS and 18,9% in NSTEACS; р=0.32). The proportion of patients that continued to follow the prescribed at discharge aspirin, clopidogrel, ticagrelor, ACE inhibitor/angiotensine receptor blocker (ARB), beta-blocker and statin was, respectively, 83,4%, 47,8%, 28,1%, 66,8%, 77,3% and 68,7%. The relation was evaluated, of the “completeness of treatment” in 6 months post ACS with the rate of fatal outcomes in 12 months. In patients, who in 6 months post ACS continued to take ≥2 groups of medications (double antiplatelet therapy, beta-blocker, ACE inhibitor/ARB, statin) the rate of fatal outcomes during 12 months was significantly higher comparing to those who were taking ≤1 group (1,4% vs. 4,9%; р=0,01). Multifactorial regression showed the independent predictors of fatal outcomes post discharge in 12 months. These were coronary arteriography in-patient (odds ratio (OR) 0,11; 95% confidence interval (95% CI) 0,02-0,56; р=0,008), age ≥75 y. o. (OR 5,48; 95% CI 1,57-19,30; р=0,008), ST elevation on baseline ECG ≥1 mm (OR 3,43; 95% CI 1,02-11,48; р=0,046). Conclusion . The analysis of data of the Russian registry RECORD-3 showed that the prevalence of fatal outcomes developed in 12 months after ACS, post discharge from hospital, was 8,4%, and the prevalence of fatal outcomes from the ACS onset — 15,8%. Best adherence to treatment in 12 months was found for aspirin (83,4%), worst — for ticagrelor (28,1%). Independent predictors of fatal outcomes in 12 months post discharge were age ≥75 y. o., not performed coronary arteriography in-patient, and ST elevation on baseline ECG ≥1 mm.