PMID- 15802360
OWN - NLM
STAT- MEDLINE
DCOM- 20050929
LR  - 20220409
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 26
IP  - 12
DP  - 2005 Jun
TI  - Management and outcome of patients with established coronary artery disease: the 
      Euro Heart Survey on coronary revascularization.
PG  - 1169-79
AB  - AIMS: The purpose of the Euro Heart Survey Programme of the European Society of 
      Cardiology is to evaluate to which extent clinical practice endorses existing 
      guidelines as well as to identify differences in population profiles, patient 
      management, and outcome across Europe. The current survey focuses on the invasive 
      diagnosis and treatment of patients with established coronary artery disease 
      (CAD). METHODS AND RESULTS: Between November 2001 and March 2002, 7769 
      consecutive patients undergoing invasive evaluation at 130 hospitals (31 
      countries) were screened for the presence of one or more coronary stenosis >50% 
      in diameter. Patient demographics and comorbidity, clinical presentation, 
      invasive parameters, treatment options, and procedural techniques were 
      prospectively entered in an electronic database (550 variables+29 per diseased 
      coronary segment). Major adverse cardiac events (MACE) were evaluated at 30 days 
      and 1 year. Out of 5619 patients with angiographically proven coronary stenosis 
      (72% of screened population), 53% presented with stable angina while ST elevation 
      myocardial infarction (STEMI) was the indication for coronary angiography in 16% 
      and non-ST segment elevation myocardial infarction or unstable angina in 30%. 
      Only medical therapy was continued in 21%, whereas mechanical revascularization 
      was performed in the remainder [percutaneous coronary intervention (PCI) in 58% 
      and coronary artery bypass grafting (CABG) in 21%]. Patients referred for PCI 
      were younger, were more active, had a lower risk profile, and had less comorbid 
      conditions. CABG was performed mostly in patients with left main lesions (21%), 
      two- (25%), or three-vessel disease (67%) with 4.1 diseased segments, on average. 
      Single-vessel PCI was performed in 82% of patients with either single- (45%), 
      two- (33%), or three-vessel disease (21%). Stents were used in 75% of attempted 
      lesions, with a large variation between sites. Direct PCI for STEMI was performed 
      in 410 cases, representing 7% of the entire workload in the participating 
      catheterization laboratories. Time delay was within 90 min in 76% of direct PCI 
      cases. In keeping with the recommendations of practice guidelines, the survey 
      identified under-use of adjunctive medication (GP IIb/IIIa receptor blockers, 
      statins, and angiotensin-converting enzyme-inhibitors). Mortality rates at 30 
      days and 1 year were low in all subgroups. MACE primarily consisted of repeat PCI 
      (12%). CONCLUSION: The current Euro Heart Survey on coronary revascularization 
      was performed in the era of bare metal stenting and provides a global European 
      picture of the invasive approach to patients with CAD. These data will serve as a 
      benchmark for the future evaluation of the impact of drug-eluting stents on the 
      practice of interventional cardiology and bypass surgery.
FAU - Lenzen, M J
AU  - Lenzen MJ
AD  - Department of Cardiology, Erasmus MC, Thoraxcenter, Rotterdam, The Netherlands.
FAU - Boersma, E
AU  - Boersma E
FAU - Bertrand, M E
AU  - Bertrand ME
FAU - Maier, W
AU  - Maier W
FAU - Moris, C
AU  - Moris C
FAU - Piscione, F
AU  - Piscione F
FAU - Sechtem, U
AU  - Sechtem U
FAU - Stahle, E
AU  - Stahle E
FAU - Widimsky, P
AU  - Widimsky P
FAU - de Jaegere, P
AU  - de Jaegere P
FAU - Scholte op Reimer, W J M
AU  - Scholte op Reimer WJ
FAU - Mercado, N
AU  - Mercado N
FAU - Wijns, W
AU  - Wijns W
CN  - European Society of Cardiology
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20050331
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
SB  - IM
CIN - Eur Heart J. 2005 Jun;26(12):1147-9. PMID: 15802359
MH  - Angina, Unstable/therapy
MH  - Angioplasty, Balloon, Coronary/methods
MH  - Coronary Artery Bypass/methods
MH  - Coronary Artery Disease/diagnosis/*therapy
MH  - Coronary Stenosis/diagnosis/*therapy
MH  - Epidemiologic Methods
MH  - Europe
MH  - Female
MH  - Guideline Adherence
MH  - Health Surveys
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/therapy
MH  - Myocardial Revascularization/*methods
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Practice Guidelines as Topic
MH  - Professional Practice/standards
MH  - Stents
MH  - Treatment Outcome
EDAT- 2005/04/02 09:00
MHDA- 2005/09/30 09:00
CRDT- 2005/04/02 09:00
PHST- 2005/04/02 09:00 [pubmed]
PHST- 2005/09/30 09:00 [medline]
PHST- 2005/04/02 09:00 [entrez]
AID - ehi238 [pii]
AID - 10.1093/eurheartj/ehi238 [doi]
PST - ppublish
SO  - Eur Heart J. 2005 Jun;26(12):1169-79. doi: 10.1093/eurheartj/ehi238. Epub 2005 
      Mar 31.