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European practice patterns for antiplatelet management in NSTE-ACS patients : Results from the REal-world ADoption survey focus on Acute antiPlatelet Treatment (READAPT) survey

Angiolillo, Dominick J. ; Erlinge, David LU orcid ; Ferreiro, José Luis ; Gale, Chris P. ; Huber, Kurt ; Musumeci, Giuseppe and Collet, Jean Philippe (2023) In International Journal of Cardiology 386. p.8-16
Abstract

Background: The 2020 European Society of Cardiology (ESC) guidelines for the diagnosis and management of patients with non-ST elevation-acute coronary syndrome (NSTE-ACS) recommend early invasive coronary angiography in high-risk patients and no routine pre-treatment with oral P2Y12 receptor inhibitor in NSTE-ACS patients prior to defining coronary anatomy. Objective: To assess the implementation of this recommendation in the real-life setting. Methods: A web-survey in 17 European countries collected physician profiles and their perceptions of the diagnosis, medical and invasive management of NSTE-ACS patients at their hospital. A sample size of at least 1100 responders permitted the estimation of proportions with a precision of at... (More)

Background: The 2020 European Society of Cardiology (ESC) guidelines for the diagnosis and management of patients with non-ST elevation-acute coronary syndrome (NSTE-ACS) recommend early invasive coronary angiography in high-risk patients and no routine pre-treatment with oral P2Y12 receptor inhibitor in NSTE-ACS patients prior to defining coronary anatomy. Objective: To assess the implementation of this recommendation in the real-life setting. Methods: A web-survey in 17 European countries collected physician profiles and their perceptions of the diagnosis, medical and invasive management of NSTE-ACS patients at their hospital. A sample size of at least 1100 responders permitted the estimation of proportions with a precision of at least ±3.0%. Results: Among the 3024 targeted participants, 1154 provided valid feedback defined as a 50% response rate of answers to the survey questions. Overall, >60% of the participants declared full implementation of the guidelines at their institution. The time delay from admission to coronary angiography and PCI was reported to be <24 h in over 75% of the hospitals while pre-treatment was intended in >50% of NSTE-ACS patients. Ad-hoc percutaneous coronary intervention (PCI) was performed in >70% of the cases while intravenous platelet inhibition was rarely used (<10%). Between countries differences in practice patterns for antiplatelet management for NSTE-ACS were observed, suggesting heterogeneous implementation of the guidelines. Conclusions: This survey indicates that the implementation of 2020 NSTE-ACS guidelines on early invasive management and pre-treatment is heterogeneous, potentially due by local logistical constraints.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Guidelines, NSTE-ACS, P2Y12 receptor inhibitors, PCI
in
International Journal of Cardiology
volume
386
pages
9 pages
publisher
Elsevier
external identifiers
  • pmid:37201617
  • scopus:85160418318
ISSN
0167-5273
DOI
10.1016/j.ijcard.2023.05.025
language
English
LU publication?
yes
id
2804255b-cdb1-4faa-bc78-3aa758c9017e
date added to LUP
2023-08-15 12:19:21
date last changed
2024-04-20 01:37:24
@article{2804255b-cdb1-4faa-bc78-3aa758c9017e,
  abstract     = {{<p>Background: The 2020 European Society of Cardiology (ESC) guidelines for the diagnosis and management of patients with non-ST elevation-acute coronary syndrome (NSTE-ACS) recommend early invasive coronary angiography in high-risk patients and no routine pre-treatment with oral P2Y12 receptor inhibitor in NSTE-ACS patients prior to defining coronary anatomy. Objective: To assess the implementation of this recommendation in the real-life setting. Methods: A web-survey in 17 European countries collected physician profiles and their perceptions of the diagnosis, medical and invasive management of NSTE-ACS patients at their hospital. A sample size of at least 1100 responders permitted the estimation of proportions with a precision of at least ±3.0%. Results: Among the 3024 targeted participants, 1154 provided valid feedback defined as a 50% response rate of answers to the survey questions. Overall, &gt;60% of the participants declared full implementation of the guidelines at their institution. The time delay from admission to coronary angiography and PCI was reported to be &lt;24 h in over 75% of the hospitals while pre-treatment was intended in &gt;50% of NSTE-ACS patients. Ad-hoc percutaneous coronary intervention (PCI) was performed in &gt;70% of the cases while intravenous platelet inhibition was rarely used (&lt;10%). Between countries differences in practice patterns for antiplatelet management for NSTE-ACS were observed, suggesting heterogeneous implementation of the guidelines. Conclusions: This survey indicates that the implementation of 2020 NSTE-ACS guidelines on early invasive management and pre-treatment is heterogeneous, potentially due by local logistical constraints.</p>}},
  author       = {{Angiolillo, Dominick J. and Erlinge, David and Ferreiro, José Luis and Gale, Chris P. and Huber, Kurt and Musumeci, Giuseppe and Collet, Jean Philippe}},
  issn         = {{0167-5273}},
  keywords     = {{Guidelines; NSTE-ACS; P2Y12 receptor inhibitors; PCI}},
  language     = {{eng}},
  pages        = {{8--16}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology}},
  title        = {{European practice patterns for antiplatelet management in NSTE-ACS patients : Results from the REal-world ADoption survey focus on Acute antiPlatelet Treatment (READAPT) survey}},
  url          = {{http://dx.doi.org/10.1016/j.ijcard.2023.05.025}},
  doi          = {{10.1016/j.ijcard.2023.05.025}},
  volume       = {{386}},
  year         = {{2023}},
}