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Comparison of the management and in‐hospital outcomes of acute coronary syndrome patients in A ustralia and N ew Z ealand: results from the binational SNAPSHOT acute coronary syndrome 2012 audit
Author(s) -
Ellis C.,
Hammett C.,
Ranasinghe I.,
French J.,
Briffa T.,
Devlin G.,
Elliott J.,
Lefkovitz J.,
AliprandiCosta B.,
Astley C.,
Redfern J.,
Howell T.,
Carr B.,
Lintern K.,
Bloomer S.,
Farshid A.,
Matsis P.,
Hamer A.,
Williams M.,
Troughton R.,
Horsfall M.,
Hyun K.,
Gamble G.,
White H.,
Brieger D.,
Chew D.
Publication year - 2015
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12739
Subject(s) - medicine , acute coronary syndrome , unstable angina , myocardial infarction , percutaneous coronary intervention , aspirin , cardiology , timi
Background/Aims We aimed to assess differences in patient management, and outcomes, of A ustralian and N ew Z ealand patients admitted with a suspected or confirmed acute coronary syndrome ( ACS ). Methods We used comprehensive data from the binational A ustralia and N ew Z ealand ACS ‘ SNAPSHOT ‘ audit, acquired on individual patients admitted between 00.00 h on 14 M ay 2012 to 24.00 h on 27 M ay 2012. Results There were 4387 patient admissions, 3381 (77%) in A ustralia and 1006 (23%) in N ew Z ealand; A ustralian patients were slightly younger (67 vs 69 years, P = 0.0044). Of the 2356 patients with confirmed ACS , A ustralian patients were at a lower cardiovascular risk with a lower median Global Registry Acute Coronary Events score (147 vs 154 P = 0.0008), but as likely to receive an invasive coronary angiogram (58% vs 54%, P = 0.082), or revascularisation with percutaneous coronary intervention (32% vs 31%, P = 0.92) or coronary artery bypass graft surgery (7.0% vs 5.6%, P = 0.32). Of the 1937 non‐segment elevation myocardial infarction/unstable angina pectoris ( NSTEMI / UAP ) patients, A ustralian patients had a shorter time to angiography (46 h vs 67 h, P < 0.0001). However, at discharge, A ustralian NSTEMI / UAP survivors were less likely to receive aspirin (84% vs 89%, P = 0.0079, a second anti‐platelet agent (57% vs 63%, P = 0.050) or a beta blocker (67% vs 77%, P = 0.0002). In‐hospital death rates were not different (2.7% vs 3.2%, P = 0.55) between A ustralia and N ew Z ealand. Conclusions Overall more similarities were seen, than differences, in the management of suspected or confirmed ACS patients between A ustralia and N ew Z ealand. However, in several management areas, both countries could improve the service delivery to this high‐risk patient group.