• Leonardo De Luca, Giuseppe Musumeci, Sergio Leonardi, Lucio Gonzini, Claudio Cavallini, Paolo Calabrò, Ciro Mauro, Luisa Cacciavillani, Stefano Savonitto, Stefano De Servi, and EYESHOT Investigators.
• aDivision of Cardiology, San Giovanni Evangelista Hospital, Rome bUSC Cardiologia, Ospedale Santa Croce e Carle, Cuneo cDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia dANMCO Research Center, Florence eDivision of Cardiology, Santa Maria della Misericordia Hospital, Perugia fDivision of Cardiology, Azienda Ospedaliera Specialistica dei Colli - Monaldi gDivision of Cardiology, Ospedale Cardarelli, Napoli hDivision of Cardiology, Azienda Ospedaliera Universitaria di Padova, Padova iDivision of Cardiology, IRCCS Multimedica, Sesto San Giovanni, Milano, Italy.
• J Cardiovasc Med (Hagerstown). 2017 Aug 1; 18 (8): 580-589.

AimsIn the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI).MethodsEmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy.ResultsOver a 3-week period, a total of 2585 consecutive ACS patients have been enrolled in 203 cardiac care units across Italy. Among these patients, 1755 underwent PCI (923 with ST-elevation myocardial infarction and 832 with non-ST-elevation ACS). In the catheterization laboratory, unfractioned heparin was the most used antithrombotic drug in both ST-elevation myocardial infarction (64.7%) and non-ST-elevation ACS (77.5%) undergoing PCI and, as aspirin, bivalirudin and glycoprotein IIb/IIIa inhibitors (GPIs) more frequently employed before or during PCI compared with the postprocedural period. Any crossover of heparin therapy occurred in 36.0% of cases, whereas switching from one P2Y12 inhibitor to another occurred in 3.7% of patients. Multivariable analysis yielded several independent predictors of GPIs and of bivalirudin use in the catheterization laboratory, mainly related to clinical presentation, PCI complexity and presence of complications during the procedure.ConclusionIn our contemporary, nationwide, all-comers cohort of ACS patients undergoing PCI, antithrombotic therapies were commonly initiated before the catheterization laboratory. In the periprocedural period, the most frequently employed drugs were unfractioned heparin, leading to a high rate of crossover, followed by GPIs and bivalirudin, mainly used during complex PCI.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT02015624.

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