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Verfasst von:Breuckmann, Frank [VerfasserIn]   i
 Hochadel, Matthias [VerfasserIn]   i
 Giannitsis, Evangelos [VerfasserIn]   i
 Senges, Jochen [VerfasserIn]   i
Titel:Guideline-adherence and perspectives in the acute management of unstable angina
Titelzusatz:initial results from the German chest pain unit registry
Verf.angabe:Frank Breuckmann, Matthias Hochadel, Harald Darius, Evangelos Giannitsis, Thomas Münzel, Lars S. Maier, Claus Schmitt, Burghard Schumacher, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Jochen Senges
Umfang:6 S.
Fussnoten:Gesehen am 24.03.2017
Titel Quelle:Enthalten in: Journal of cardiology
Jahr Quelle:2015
Band/Heft Quelle:66(2015), 2, S. 108-113
ISSN Quelle:1876-4738
Abstract:Background We investigated the current management of unstable angina pectoris (UAP) in certified chest pain units (CPUs) in Germany and focused on the European Society of Cardiology (ESC) guideline-adherence in the timing of invasive strategies or choice of conservative treatment options. More specifically, we analyzed differences in clinical outcome with respect to guideline-adherence. Method Prospective data from 1400 UAP patients were collected. Analyses of high-risk criteria with indication for invasive management and 3-month clinical outcome data were performed. Guideline-adherence was tested for a primarily conservative strategy as well as for percutaneous coronary intervention (PCI) within <24 and <72 h after admission. Results Overall guideline-conforming management was performed in 38.2%. In UAP patients at risk, undertreatment caused by an insufficient consideration of risk criteria was obvious in 78%. Reciprocally, overtreatment in the absence of adequate risk markers was performed in 27%, whereas a guideline-conforming primarily conservative strategy was chosen in 73% of the low-risk patients. Together, the 3-month major adverse coronary and cerebrovascular events (MACCE) were low (3.6%). Nonetheless, guideline-conforming treatment was even associated with significantly lower MACCE rates (1.6% vs. 4.0%, p < 0.05). Conclusion The data suggest an inadequate adherence to ESC guidelines in nearly two thirds of the patients, particularly in those patients at high to intermediate risk with secondary risk factors, emphasizing the need for further attention to consistent risk profiling in the CPU and its certification process.
DOI:doi:10.1016/j.jjcc.2014.11.003
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Verlag: http://dx.doi.org/10.1016/j.jjcc.2014.11.003
 Verlag: http://www.sciencedirect.com/science/article/pii/S0914508714003293
 DOI: https://doi.org/10.1016/j.jjcc.2014.11.003
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:155590212X
Verknüpfungen:→ Zeitschrift

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