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International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries.

dc.contributor.author McNamara, RL
dc.contributor.author Chung, SC
dc.contributor.author Jernberg, T
dc.contributor.author Holmes, D
dc.contributor.author Roe, M
dc.contributor.author Timmis, A
dc.contributor.author James, S
dc.contributor.author Deanfield, J
dc.contributor.author Fonarow, GC
dc.contributor.author Peterson, ED
dc.contributor.author Jeppsson, A
dc.contributor.author Hemingway, H
dc.coverage.spatial Netherlands
dc.date.accessioned 2017-06-01T16:37:14Z
dc.date.available 2017-06-01T16:37:14Z
dc.date.issued 2014-08-01
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/24882696
dc.identifier S0167-5273(14)00967-X
dc.identifier.uri https://hdl.handle.net/10161/14641
dc.description.abstract OBJECTIVES: To compare management of patients with acute non-ST segment elevation myocardial infarction (NSTEMI) in three developed countries with national ongoing registries. BACKGROUND: Results from clinical trials suggest significant variation in care across the world. However, international comparisons in "real world" registries are limited. METHODS: We compared the use of in-hospital procedures and discharge medications for patients admitted with NSTEMI from 2007 to 2010 using the unselective MINAP/NICOR [England and Wales (UK); n=137,009], the unselective SWEDEHEART/RIKS-HIA (Sweden; n=45,069), and the selective ACTION Registry-GWTG/NCDR [United States (US); n=147,438] clinical registries. RESULTS: Patients enrolled among the three registries were generally similar except those in the US who were younger but had higher rates of smoking, diabetes, hypertension, prior heart failure, and prior MI than in Sweden or in UK. Angiography and percutaneous coronary intervention (PCI) were performed more often in the US (76% and 44%) and Sweden (65% and 42%) relative to the UK (32% and 22%). Discharge betablockers were also prescribed more often in the US (89%) and Sweden (89%) than in the UK (76%). In contrast, discharge statins, angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB), and dual antiplatelet agents (among those not receiving PCI) were higher in the UK (92%, 79%, and 71%) than in the US (85%, 65%, 41%) and Sweden (81%, 69%, and 49%). CONCLUSIONS: The care for patients with NSTEMI differed substantially among the three countries. These differences in care among countries provide an opportunity for future comparative effectiveness research as well as identify opportunities for global quality improvement.
dc.language eng
dc.publisher Elsevier BV
dc.relation.ispartof Int J Cardiol
dc.relation.isversionof 10.1016/j.ijcard.2014.04.270
dc.subject Acute myocardial infarction
dc.subject Clinical registries
dc.subject International comparisons
dc.subject Treatment
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Anticoagulants
dc.subject Disease Management
dc.subject Female
dc.subject Humans
dc.subject Internationality
dc.subject Male
dc.subject Middle Aged
dc.subject Myocardial Infarction
dc.subject Percutaneous Coronary Intervention
dc.subject Registries
dc.subject Sweden
dc.subject United Kingdom
dc.subject United States
dc.title International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries.
dc.type Journal article
duke.contributor.id Roe, M|0079636
duke.contributor.id Peterson, ED|0130909
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/24882696
pubs.begin-page 240
pubs.end-page 247
pubs.issue 2
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 175
dc.identifier.eissn 1874-1754
duke.contributor.orcid Peterson, ED|0000-0002-5415-4721


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