Comparison Of The Diagnosis And Management Of Patients With Non-ST Elevation Acute Coronary Syndrome Between 2000 And 2006 In A Teaching Hospital

Objective and BackgroundNon-ST elevation acute coronary syndrome(NSTE-ACS)contains unstable angina(UA)and non-ST segment Elevated Myocardial(NSTEMI).NSTE-ACS has witnessed a rapid evolution in therapeutic options for patients recently.The American College of Cardiology(ACC),American Heart Association(AHA)and the European Society of Cardiology(ESC)have reached largely consistent interpretations and recommendations based on analyses of the published trial data and meta-analyses,guideline groups..Nevertheless,substantial gaps exist between guidelines for the management of NSTE-ACS and current p ractive.The destionation of this research is to compare the diagnosis and management of patients with Non-ST elevation acute coronary syndrome between 2000 and 2006(6 years)from the first affiliated hospital of Zhejiang University,scale the gap between practice and guidelines.MethodsClinical data of 547 inpatients with Non-ST elevation acute coronary syndrome: were retrospectively analyzed from Jan to Dec in 2000 and 2006.There were 175 inpatients in group 2000 and 372 inpatients in group 2006.The materials of the two separate different years patients were compared.All results were expressed as means±SD.The data were analyzed by SPSS 13.0.A value of P＜0.05 was considered to be statistically significant.ResultsElevated cardiac markers,chest X-Ray,echocardiography,dynamic electrocardiogram,exercise ECG,coronary angiography(76.9%vs63.4%,P＜0.01) were used more in 2006 than those in 2000(P＜0.05),but the usage of cardiac stress imaging and electron-beam computed tomography was lower(P＜0.05).Significant increases in the use of aspirin,using 300mg first dosage of aspirin,β-blocker,ACEI,thienopyridine,GPⅡb/Ⅲa inhibitor,statins and invasive strategies(51.1% vs35.4%,P＜0.01)were found between 2006 and 2000(P＜0.05).The utilization rate of morphine sulfate,nitrates,unfractionated heparin were lower(P＜0.05).ConclusionsThere were great progress in the diagnosis and management of patients with Non-ST elevation acute coronary syndrome between 2000 and 2006.Still,further improvements are needed for optimal implementation of these guidelines such as the use ofβ-blocker,adding dosage ofβ-blocker,GPⅡb/Ⅲa inhibitor,low-molecular-weight heparin.