Outcomes, Health Costs and Use of Antiplatelet Agents in 7,082 Patients Admitted for an Acute Coronary Syndrome Occurring in a Large Community Setting

Purpose To assess the outcomes of patients admitted for ACS and the prescription pattern of antiplatelets of patients discharged alive. Methods From the ARNO Observatory database, we performed a record linkage analysis of hospital discharge and prescription databases, which included 2,758,872 subjects of 7 Italian Local Health Authorities. The accrual period lasted from January 1 to December 31, 2008. Discharge records and prescription patterns were analyzed for 1 year before and after the accrual period. Results Of 2,758,872 subjects, 7,082 (2.6‰) were hospitalized for ACS. Mean age was 72 ± 13 years, females and diabetics accounted for 36 % and 25 % of the cases. Of the 7,082 patients, in-hospital death occurred in 6.9 %. Of the survivors, 64.5 % was treated medically, 35.5 % with PCI. Of the patients discharged alive, 65.8 % were treated with an antiplatelet, 21.9 % aspirin alone, 33.1 % aspirin plus a thienopyridine (mostly clopidogrel), 10.5 % a thienopyridine alone. Dual antiplatelet treatment was prescribed more frequently in patients treated with PCI than in those treated medically (57.3 % vs 19.7 %, p