[Registry of Acute Coronary Syndromes RECORD-3. Characteristics of Patients and Treatment During Initial Hospitalization].

Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization.

MATERIAL AND METHODS: RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive") during 1 month.

RESULTS: Number of included pts was 2370 (39% women, mean age 64.6 years), 72% were admitted to invasive hospitals, 37% had ST-elevation ACS (STEACS). Median "onset of symptoms - first medical contact" time was 3.4 (1.0-16.8) hours, "first medical contact - hospital admission" time - 1.5 (1.0-3.1) hours. Cardiac troponin was determined in 76% of pts. Coronary angiography was carried out in 70 and 46% of pts with STE and non-STE ACS, respectively. (16% of all patients hospitalized in "noninvasive" cetnters were transferred for angiography to invasive ones). Primary percutaneous coronary intervention (PCI) was performed in 39% of patients with STEACS (in 65% of them with "door to pPCI" time less or equal 90 min). Thrombolytic therapy (TLT) was administered to 32% of pts (in half of them prehospitally). Overall reperfusion therapy received 68% of pts. Among non-STEACS pts rate of PCI was 20% (1/3 of procedures within 2, 1/3 - >2-24hours). Inhospital antiplatelet therapy (APT) included aspirin (88%), clopidogrel (71%), ticagrelor (14%); 86% of pts received dual APT. Other medications were: unfractionated heparin (UFH, 47% [81% subcutaneously]), enoxaparin (13%), fondaparinux (10%), angiotensin converting enzyme inhibitors/sartans (81%), -adrenoblockers (84%), statins (87%). Mortality during hospitalization (median 10 days) was 10% in STE, and 5% in non-STE ACS.

CONCLUSION: Inhospital management of RECORD-3 population was characterized by relatively low rates of pPCI, reperfusion therapy in STEACS, urgent PCI in non-STEACS. Preponderance of UFG including its subcutaneous use is of note. Use of other standard therapies appears satisfactory.