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May 1, 2007JAMA

Decline in Rates of Death and Heart Failure in Acute Coronary Syndromes, 1999-2006

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Why the study?

Does the increased use of evidence-based pharmacological and interventional therapies over time improve clinical outcomes in patients with acute coronary syndromes?

Population

44,372 patients with acute coronary syndromes enrolled in the Global Registry of Acute Coronary Events…

Comparison

Increased use of evidence-based pharmacological… vs Earlier time periods.

Design

Cohort

Follow-up

6 months

Authors

KFKeith A.A. FoxPSPhilippe Gabríel StegKEKim A. Eagle

Discussion

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Member takes

Overview

Declining HF rates in ACS may reflect wider therapy adoption; supports associations but leaves causality open without RCTs.

Structured PICO

Does the increased use of evidence-based pharmacological and interventional therapies over time improve clinical outcomes in patients with acute coronary syndromes?

P
Population
44,372 patients with acute coronary syndromes (STEMI and NSTE ACS) enrolled in the Global Registry of Acute Coronary Events (GRACE) across 113 hospitals in 14 countries between July 1, 1999, and December 31, 2006.
I
Intervention
Increased use of evidence-based pharmacological therapies (beta-blockers, statins, angiotensin-converting enzyme inhibitors, thienopyridines, glycoprotein IIb/IIIa inhibitors, low-molecular-weight heparin) and interventional therapies (percutaneous coronary intervention) over time.
C
Comparator
Earlier time periods (historical practice patterns within the same cohort from 1999 to 2006).
O
Outcome
Temporal trends in the use of evidence-based therapies and patient outcomes (death, congestive heart failure, pulmonary edema, cardiogenic shock, stroke, myocardial infarction).hard clinical

Increased adoption of evidence-based pharmacological and interventional therapies for acute coronary syndromes between 1999 and 2006 was associated with significant real-world reductions in mortality, heart failure, stroke, and myocardial infarction.

Cite This Study

Fox et al. (2007) studied this question.

synapsesocial.com/papers/6a7cb32cb7ca9b673b7cd2cehttps://doi.org/10.1001/jama.297.17.1892
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