• Alberto Cordero, Ramón López-Palop, Pilar Carrillo, Araceli Frutos, Sandra Miralles, Clara Gunturiz, María García-Carrilero, and Vicente Bertomeu-Martínez.
• Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain. Electronic address: acorderofort@gmail.com.
• Rev Esp Cardiol (Engl Ed). 2016 Aug 1; 69 (8): 754-9.

Introduction And ObjectivesEmergency care systems have been created to improve treatment and revascularization in myocardial infarction but they may also improve the management of all patients with acute coronary syndrome.MethodsA comparative study of all patients admitted with acute coronary syndrome before and after implementation of an infarction protocol.ResultsThe study included 1210 patients. While the mean age was the same in both periods, the patient group admitted after implementation of the protocol had a lower prevalence of diabetes mellitus and hypertension but more active smokers and higher GRACE scores. The percentage of ST-segment elevation acute coronary syndrome (29.8%-39.5%) and coronary revascularizations (82.1%-90.1%) significantly increased among patients admitted with acute coronary syndrome, and primary angioplasty became routine (51.9%-94.9%); there was also a reduction in time to catheterization and an increase in early revascularization. The mean hospital stay was significantly shorter after implementation of the infarction protocol. In-hospital mortality was unchanged, except in high-risk patients (38.8%-22.4%). After discharge, no differences were observed between the 2 periods in cardiovascular mortality, all-cause mortality, reinfarction, or major cardiovascular complications.ConclusionsAfter implementation of the infarction protocol, the percentage of patients admitted with ST-segment elevation acute coronary syndrome and the mean GRACE score increased among patients admitted with acute coronary syndrome. Hospital stay was reduced, and primary angioplasty use increased. In-hospital mortality was reduced in high-risk patients, and prognosis after discharge was the same in both periods.Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

31 keywords...

hide…