AIMS: To better delineate the characteristics, treatments, and outcomes of patients with acute coronary syndromes (ACS) in representative countries across Europe and the Mediterranean basin, and to examine adherence to current guidelines. METHODS AND RESULTS: We performed a prospective survey (103 hospitals, 25 countries) of 10484 patients with a discharge diagnosis of acute coronary syndromes. The initial diagnosis was ST elevation ACS in 42.3%, non-ST elevation ACS in 51.2%, and undetermined electrocardiogram ACS in 6.5%. The discharge diagnosis was Q wave myocardial infarction in 32.8%, non-Q wave myocardial infarction in 25.3%, and unstable angina in 41.9%. The use of aspirin, beta-blockers, angiotensin converting enzyme inhibitors, and heparins for patients with ST elevation ACS were 93.0%, 77.8%, 62.1%, and 86.8%, respectively, with corresponding rates of 88.5%, 76.6%, 55.8%, and 83.9% for non-ST elevation ACS patients. Coronary angiography, percutaneous coronary interventions, and coronary bypass surgery were performed in 56.3%, 40.4%, and 3.4% of ST elevation ACS patients, respectively, with corresponding rates of 52.0%, 25.4%, and 5.4% for non-ST elevation ACS patients. Among patients with ST elevation ACS, 55.8% received reperfusion treatment; 35.1% fibrinolytic therapy and 20.7% primary percutaneous coronary interventions. The in-hospital mortality of patients with ST elevation ACS was 7.0%, for non-ST elevation ACS 2.4%, and for undetermined electrocardiogram ACS 11.8%. At 30 days, mortality was 8.4%, 3.5%, and 13.3%, respectively. CONCLUSIONS: This survey demonstrates the discordance between existing guidelines for ACS and current practice across a broad region in Europe and the Mediterranean basin and more extensively reflects the outcomes of ACS in real practice in this region

*Outcome and Process Assessment (Health Care), *Practice Guidelines, Acute Disease, Aged, Angina, Unstable/diagnosis/therapy, Angioplasty, Transluminal, Percutaneous Coronary, Diagnostic Techniques, Cardiovascular, Electrocardiography, Europe, Female, Fibrinolytic Agents/therapeutic use, Health Care Surveys, Heart Diseases/*diagnosis/epidemiology/physiopathology/*therapy, Hemodynamic Processes, Humans, Male, Mediterranean Region, Middle aged, Myocardial Infarction/diagnosis/therapy, Prospective Studies, Registries, Reperfusion, Research Support, Non-U.S. Gov't, Syndrome,
European Heart Journal
Erasmus MC: University Medical Center Rotterdam

Hasdai, D, Behar, S, Wallentin, L.C, Danchin, N, Gitt, A.K, Fioretti, P.M, … Boersma, H. (2002). A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). European Heart Journal, 23(15), 1190–1201. doi:10.1053/euhj.2002.3193