68 Stroke / Infarction acute phase non STEMI

68
Stroke / Infarction acute phase non STEMI
ASA had significantly worse NIHSS and mRS than those not taking ASA (16 vs.
12 and 5.6 vs. 4.2).
Conclusion: Plasma fibrinogen is significantly higher in acute ischemic stroke
than in ICH or SAH while there was no significant difference in platelet count
and MPV in acute phase. Taking ASA before stroke has slight positive impact on
outcome in ischemic stroke but great negative in haemorrhagic stroke.
INFARCTION ACUTE PHASE NON STEMI
P412 | BEDSIDE
Differences in incidence of hospital admissions for acute coronary
syndromes in five Western countries
U. Zeymer 1 , L. Eckert 2 , I. Dubroca 2 . 1 Institut für Herzinfarktforschung,
Ludwigshafen Am Rhein, Germany; 2 Sanofi, Paris, France
France
Germany
Italy
Hospitalizations for ACS per given year
All ACS types
146,735
340,154
230,198
Hospitalization rate per 100 000 inhabitants ≥18 years
STEMI
101
121
146
NSTE-ACS
190
378
323
Proportion by type of ACS, %
STEMI
34.6
24.2
31.1
NSTE-ACS
65.4
75.8
68.9
UK
USA
150,638
671,260
49
257
77
212
16.2
83.8
26.6
73.4
Conclusions: ACS remains an important cause of hospitalization in the US and
Europe despite the advances made in primary and secondary prevention therapies. NSTE-ACS events represent the highest burden, representing almost 3 of
every 4 hospitalizations for ACS. Inter-country differences in the ratio of NSTEACS to STEMI need further research.
Age (years)
Female gender (%)
Prior MI (%)
Prior PCI (%)
Prior CABG (%)
Prior stroke (%)
Killip 4 (%)
Multivessel disease (%)
Revascularisation Treatment
PCI (%)
Hospital Outcome
Death
MI
Stroke
No Diab
No RF
n=8487
Dia +
No RF
n=3309
No Diab
RF +
n=520
Diab +
RF +
n=517
67
34.6
26.0
15.2
5.4
5.2
0.9
64.1
71
42.8
33.9
21.4
8.5
8.1
1.3
72.6
78
31.3
42.0
25.9
11.8
9.6
1.3
75.3
75
35.2
52.0
30.7
15.3
13.0
3.4
85.0
43.4
42.4
39.6
39.7
2.7
1.3
0.4
3.2
1.3
0.5
7.9
2.0
0.5
8.3
2.0
0.6
Abstract P413 – Figure 1
P414 | BEDSIDE
Blood transfusion per se does not impact survival in AMI patients.
A propensity-score analysis from the French FAST-MI 2005 registry
G. Ducrocq 1 , E. Puymirat 2 , N. Danchin 2 , P. Henry 3 , M. Martelet 4 , P.V. Ennezat 5 ,
F. Schiele 6 , P.G. Steg 1 , J. Ferrieres 7 , T. Simon 8 on behalf of FAST-MI
investigators. 1 AP-HP - Hospital Bichat-Claude Bernard, Department of
Cardiology, Paris, France; 2 AP-HP - European Hospital Georges Pompidou,
Paris, France; 3 AP-HP - Hospital Lariboisiere, Department of Cardiology,
Paris, France; 4 General Hospital Langres, Langres, France; 5 Eaux-Claires
Clinic, Grenoble, France; 6 University Hospital of Besancon, Besancon, France;
7 University Hospital of Toulouse, Toulouse, France; 8 AP-HP - Hospital Saint
Antoine, Paris, France
Background and aim: The possible intrinsic toxicity of blood transfusions in patients with acute coronary syndromes is debated. We assessed 5-year mortality
according to use of blood transfusion in AMI patients.
P413 | BEDSIDE
Renal failure but not diabetes determines hospital mortality in
patients with NSTE-ACS - results of the Euro heart survey
ACS-registry
A.K. Gitt 1 , M. Hochadel 2 , W. Wojakowski 3 , U. Zeymer 1 , M. Tendera 3 ,
F. Schiele 4 , R. Zahn 2 , J.P. Bassand 4 on behalf of Euro Heart Survey ACS
Registry Study Group. 1 Herzzentrum Ludwigshafen, Med. Klinik B, Kardiologie
+ Institut f. Herzinfarktforschung Ludwigshafen, Ludwigshafen am Rhein,
Germany; 2 Institut f. Herzinfarktforschung Ludwigshafen, Ludwigshafen am
Rhein, Germany; 3 Medical University of Silesia, 1st Department of Cardiology,
Katowice, Poland; 4 University Hospital of Besancon - Hospital Jean Minjoz,
Department of Cardiology, Besancon, France
Background: Patients with NSTE-ACS often have diabetes (Diab) and/or renal
failure (RF). It is unclear if RF and Diab are independent predictors of hospital
mortality in NSTE-ACS.
Methods: In 2006 to 2008, consecutive patients with ACS were enrolled into the
EHS-ACS-Registry to document treatment and hospital outcome. We examined
the impact of Diab and RF (GFR <60 ml/kg/min) on hospital outcome in patients
with NSTE-ACS.
Results: Of all ACS, 12,833 presented with NSTE-ACS. Patients with RF were
older and more often had concomitant diseases as well as prior myocardial infarctions and coronary interventions independent of the presence of Diab. Patients
with RF were less likely to undergo early reperfusion therapy (PCI <48h of symptom onset) as compared to patients without RF. In multivariate analysis, RF but
not Diab predicted hospital mortality (p<0.05).
Conclusion: In patients with NSTE-ACS, RF outplayed Diab in the prediction of
hospital mortality in NSTE-ACS and might be more important in risk stratification
than Diab.
5-year survival according to transfusion
Downloaded from by guest on October 28, 2014
Aim: Limited global data are available on the incidence of acute coronary
syndromes (ACS), and particularly non-ST-elevation acute coronary syndromes
(NSTE-ACS). Based on national hospital databases in France, Germany, Italy,
UK, and USA, we assessed hospitalization rates for ACS within each country
over 1 year.
Methods: Patients hospitalized with a principal diagnosis of ACS, NSTE-ACS
(including non-ST-elevation myocardial infarction and unstable angina), or STelevation myocardial infarction (STEMI) were identified from admission records in
national databases using International Classification of Diseases (ICD) diagnosis
codes (ICD-9 for Italy, USA; ICD-10 for France (mapping), Germany, UK). Hospitalizations for ACS were evaluated by country and by comparable age groups
available for USA and Germany.
Results: Crude hospitalization rates for NSTE-ACS and STEMI varied from 50
to 146/ 100,000 adults and 190 to 378/100,000 adults, respectively. NSTE-ACS
comprised 65-84% of hospitalizations for ACS (Table). Age-adjusted hospitalization rates were higher for NSTE-ACS vs. STEMI in all age groups evaluated, particularly in adults aged 65-84 years Age-adjusted hospitalization rates for STEMI
and NSTE-ACS were comparable between USA and Germany for all age groups,
except for the higher rate of NSTE-ACS hospitalizations in German adults aged
65-84 years.
Abstract P413 – Table 1