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In-Hospital Coronary Revascularization Rates and Post-Discharge Mortality Risk in Non-ST-Segment Elevation Acute Coronary Syndrome.

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dc.contributor.authorBueno, Hector
dc.contributor.authorRossello, Xavier
dc.contributor.authorPocock, Stuart J
dc.contributor.authorVan de Werf, Frans
dc.contributor.authorChin, Chee Tang
dc.contributor.authorDanchin, Nicolas
dc.contributor.authorLee, Stephen W-L
dc.contributor.authorMedina, Jesús
dc.contributor.authorHuo, Yong
dc.contributor.funderFundación AstraZeneca
dc.contributor.funderFundación ProCNIC
dc.contributor.funderInstituto de Salud Carlos III
dc.contributor.funderMinisterio de Economía y Competitividad (España)
dc.contributor.funderBristol-Myers Squibb
dc.contributor.funderNovartis
dc.date.accessioned2020-10-30T14:35:41Z
dc.date.available2020-10-30T14:35:41Z
dc.date.issued2019-09
dc.description.abstractThe relationship between in-hospital coronary revascularization rate (CRR) and post-discharge mortality rates in survivors of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) at a system level is unclear. The purpose of this study was to evaluate CRR and 2-year post-discharge mortality rate (2YMR) in NSTE-ACS. CRR and 2YMR were analyzed by hospital rate of CRR (in deciles), by country, and by world region in 11,931 patients with NSTE-ACS who survived to discharge and were enrolled in the EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients) and EPICOR Asia: twin multinational, observational, prospective cohort studies. Significant differences in patient baseline characteristics, medical therapies, CRR, and 2YMR were found. Mean CRR ranged from 0.0% to 96.8% in the first and tenth decile, respectively (p < 0.001); from 12.3% in Romania to 92.4% in Slovenia (p < 0.001); and from 53.9% in South East Asia (SEAsia) to 90.4% in South Korea-Singapore-Hong Kong. 2YMR varied significantly between hospital deciles of CRR (3.6% in tenth decile vs. 9.2% in first decile; p < 0.001), countries (lowest 1.5% in Slovenia, highest 19.4% in Malaysia; p < 0.001), and regions (lowest 3.8% in South Korea-Singapore-Hong Kong, highest 11.7% in SEAsia; p < 0.001). Poisson regression models, adjusted for 15 mortality predictors, showed a significant inverse association between CRR and 2YMR for hospitals (r = -0.90; p < 0.001), countries (r = -0.65; p < 0.001), and regions (r = -0.87; p = 0.005). Higher CRRs at the hospital, country, and world region levels are strongly associated with higher post-discharge survival, suggesting CRR as a marker of higher system quality.es_ES
dc.description.peerreviewedSíes_ES
dc.description.sponsorshipThe EPICOR and EPICOR Asia studies were funded by AstraZeneca. The CNIC is supported by the Spanish Ministry of Economy and Competitiveness (MINECO) and the Pro-CNIC Foundation, and is a Severo Ochoa Center of Excellence (MINECO award SEV-2015-0505). Dr. Bueno has received research funding from the Instituto de Salud Carlos III, Spain (PIE16/00021 and PI17/01799), AstraZeneca, Bristol-Myers Squibb, Janssen, and Novartis; has received consulting fees from AstraZeneca, Bayer, Bristol-Myers Squibb-Pfizer, and Novartis; and has received speaker fees or support for attending scientific meetings from AstraZeneca, Bayer, Bristol-Myers Squibb-Pfizer, Ferrer, Novartis, and MEDSCAPE-the heart.org. Dr. Rossello has received support from the SEC-CNIC CARDIOJOVEN fellowship program. Dr. Pocock has received research funding from AstraZeneca. Dr. Van de Werf has received consulting fees and research grants from Boehringer Ingelheim, Merck, and Sanofi; and has received consulting and speaker fees from Boehringer Ingelheim, Roche, Sanofi, AstraZeneca, and The Medicines Company. Dr. Chin has received consulting or speaker fees from AstraZeneca, Merck, Servier, and Medtronic. Dr. Danchin has received consulting or Speaker fees from Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, Merck Sharp & Dohme, Novo Nordisk, Pfizer, Sanofi, and Servier. Dr. Medina is an employee of AstraZenecaes_ES
dc.format.number11es_ES
dc.format.page1454-1461es_ES
dc.format.volume74es_ES
dc.identifier.citationJ Am Coll Cardiol. 2019; 74(11):1454-1461es_ES
dc.identifier.doi10.1016/j.jacc.2019.06.068es_ES
dc.identifier.journalJournal of the American College of Cardiologyes_ES
dc.identifier.pubmedID31514947es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/11267
dc.language.isoenges_ES
dc.publisherElsevieres_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/ES/SEV-2015-0505es_ES
dc.relation.publisherversionhttps://doi.org/10.1016/j.jacc.2019.06.068es_ES
dc.repisalud.institucionCNICes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Investigación Cardiovascular Traslacional Multidisciplinariaes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Laboratorio Traslacional para la Imagen y Terapia Cardiovasculares_ES
dc.rights.accessRightsopen accesses_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subject.meshHospitalizationes_ES
dc.subject.meshAcute Coronary Syndromees_ES
dc.subject.meshAgedes_ES
dc.subject.meshFemalees_ES
dc.subject.meshHumanses_ES
dc.subject.meshMalees_ES
dc.subject.meshMiddle Agedes_ES
dc.subject.meshPatient Dischargees_ES
dc.subject.meshPercutaneous Coronary Interventiones_ES
dc.subject.meshProspective Studieses_ES
dc.subject.meshRisk Assessmentes_ES
dc.subject.meshSurvival Ratees_ES
dc.subject.meshTime Factorses_ES
dc.titleIn-Hospital Coronary Revascularization Rates and Post-Discharge Mortality Risk in Non-ST-Segment Elevation Acute Coronary Syndrome.es_ES
dc.typejournal articlees_ES
dc.type.hasVersionVoRes_ES
dspace.entity.typePublication
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