The incidence, treatment strategies and outcomes of acute coronary syndromes in the “reperfusion network” of different hospital types in the Czech Republic: Results of the Czech evaluation of acute coronary syndromes in hospitalized patients (CZECH) regis

Aims To analyze the incidence, treatment strategies and outcomes of acute coronary syndromes (ACS) in Czech population. Methods and results ACS diagnosis was confirmed in 1345 of 1921 (70%) consecutively admitted patients with suspected ACS. ACS incidence was 3248 cases/million/year and the annual incidence of confirmed myocardial infarction was 1960 per million. In-hospital mortality was 5.1% (10.0% with Q-MI, 4.4% with non-Q-MI, and 0.9% with UAP). Coronary angiography was performed in 92% of STEMI (followed by primary PCI in 83%, by CABG in 3%, by conservative therapy in 6%). Thrombolysis was used in only 1% of patients. Reperfusion therapy was thus used in 87% of all STEMI patients. Discharge medication included aspirin in 95%, a statin in 76%, a beta-blocker in 78%, an ACE inhibitor in 50%, clopidogrel in 60%, and ticlopidine in 4% of patients. Conclusions In-hospital mortality of ACS in the Czech network of PCI and non-PCI hospitals is low. Nationwide application of primary PCI strategy for STEMI is feasible and increases the overall use of reperfusion therapy.