ArticleHeart (British Cardiac Society)2005
Contemporary management of acute coronary syndromes: does the practice match the evidence? The global registry of acute coronary events (GRACE).
Article in Heart (British Cardiac Society), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
19 citing papers in PubMed, 89 citations in OpenAlex.
- Observational
- Article
- Challenges and opportunities associated with quantification of cardiovascular readmissions.Journal of the American Heart Association · 2014Review
- Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: results from a large prospective audit in Australia and New Zealand.Heart (British Cardiac Society) · 2014Article
- Acute coronary syndrome in Australia: Where are we now and where are we going?The Australasian medical journal · 2014Review
- Mortality Trends in Patients Hospitalized with the Initial Acute Myocardial Infarction in a Middle Eastern Country over 20 Years.Cardiology research and practice · 2014Article
- Mimics of acute coronary syndrome on MDCT.Emergency radiology · 2013Article
- Predictive models for short- and long-term adverse outcomes following discharge in a contemporary population with acute coronary syndromes.American journal of cardiovascular disease · 2013Article
- Secondary revascularization after CABG surgery.Nature reviews. Cardiology · 2012Review
- Prediction of persistence of combined evidence-based cardiovascular medications in patients with acute coronary syndrome after hospital discharge using neural networks.Medical & biological engineering & computing · 2011Article
- Trends in the Use of Evidence-based Therapies Early in the Course of Acute Myocardial Infarction and its Influence on Short Term Patient Outcomes.The open cardiovascular medicine journal · 2011Article
- Antithrombotic therapy in acute coronary syndromes: guidelines translated for the clinician.Journal of thrombosis and thrombolysis · 2010Review
- The use of risk scores for stratification of non-ST elevation acute coronary syndrome patients.Experimental and clinical cardiology · 2009Article
- Management of acute myocardial infarction in the real world: a summary report from The Ami-Florence Italian Registry.Internal and emergency medicine · 2008Article
- Risk assessment after acute coronary syndrome.BMJ (Clinical research ed.) · 2006Article
- [Clinical pathway "Acute Coronary Syndrome"].Der Internist · 2006Review
- Long term clinical outcome and bleeding complications among hospital survivors with acute coronary syndromes.Postgraduate medical journal · 2006Article
- National variations in mortality and functional outcome: should we be worried?Journal of neurology, neurosurgery, and psychiatry · 2006Article
- Creation and Implementation of a Prospective and Multicentric Database of Patients with Acute Myocardial Infarction: RIAM.Arquivos brasileiros de cardiologiaArticle
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine to what extent evidence based guidelines are followed in the management of acute coronary syndromes (ACS) in the UK, elsewhere in Europe, and multinationally, and what the outcomes are.
designMultinational, prospective, observational registry (GRACE, global registry of acute coronary events) with six months' follow up.
settingPatients presenting to a cluster of hospitals. The study was designed to collect data representative of the full spectrum of ACS in specific geographic populations. PATIENTS: Patients admitted with a working diagnosis of unstable angina or suspected myocardial infarction (MI).
main outcome measuresDeath during hospitalisation and at six months' follow up (adjusted for baseline risks).
resultsIn ST elevation MI, reperfusion was applied more often in the UK (71%) than in Europe (65%) and multinationally (59%) (p < 0.01). However, this was almost entirely by lytic treatment, in contrast with elsewhere (primary percutaneous coronary intervention 1%, 29%, 16%, respectively). Statins were applied more frequently in the UK for all classes of patients with ACS (p < 0.0001). In contrast there was lower use of revascularisation procedures in non-ST MI (20% v 37% v 28%, respectively) and glycoprotein IIb/IIIa antagonists (6% v 25% v 26%, respectively). In-hospital death rates, adjusted for baseline risk, were not significantly different but six month death rates were higher in the UK for ST elevation MI (7.2% UK, 4.3% Europe, 5.3% multinationally; p < 0.0001) and non-ST elevation MI (7.5%, 6.2%, and 6.7%, respectively; p = 0.012, UK v Europe).
conclusionsCurrent management of ACS in the UK more closely follows the recommendations of the National Service Framework than British or European guidelines. Differences in practice may account for the observed higher event rates in the UK after hospital discharge.
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