Materiały źródłowe

• #1 Acute Coronary Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459157/

  Acute coronary syndrome (ACS) refers to a group of conditions that include ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina. It is a type of coronary heart disease (CHD), which is responsible for one-third of total deaths in people older than 35. Some forms of CHD can be asymptomatic, but ACS is always symptomatic. […] CHD affects about 15.5 million in the United States. The American Heart Association estimates a person has a heart attack every 41 seconds. Heart disease is the leading cause of death in the United States. Chest pain is among the top reasons for emergency department visits. […] Coronary heart disease and acute coronary syndrome remain widely prevalent and still is the top cause of death in people over 35 years of age. It is essential that providers all over the world maintain a high degree of suspicion and vigilance while assessing patients with possible ACS. Along with this, public education and recognition of symptoms are crucial. Another important aspect of controlling this disease is public education about lifestyle modification and making people aware of healthier life choices. A critical aspect of STEMI and ACS timely treatment depends on adequate emergency medical services availability and training. Another crucial step of ACS control and prevention is education about lifestyle modification including smoking cessation, regular physical activity, and dietary modifications. Only through this multi-prong approach can practitioners control this high mortality disease.

• #2 The evolving epidemiology of acute coronary syndromes | Nature Reviews Cardiology

  https://www.nature.com/articles/nrcardio.2010.199

  The clinical entities that comprise acute coronary syndromes (ACS)ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable anginahave been recognized as widespread causes of death and disability for more than a century. […] Epidemiological studies have provided insight into the changing demographics of ACS, and highlighted the importance of modifiable risk factors and adherence to guideline-recommended therapy. […] The prevalence of acute coronary syndromes (ACS) has reached a pandemic level as a consequence of modernization of the developing world. […] Epidemiological surveillance and population-based studies will be essential to evaluate the successful translation of evidence-based medicine into clinical practice.

• #3 You must be logged in as a member to save to your library.

  https://www.acc.org/Latest-in-Cardiology/Articles/2024/06/01/01/42/Cover-Story-Acute-Coronary-Syndromes-New-Perspectives-New-Data

  In the rapidly evolving health care landscape, acute coronary syndromes (ACS) continue to be a leading cause of morbidity and mortality worldwide. Each year, an estimated 1.2 million individuals in the U.S. are hospitalized with ACS. STEMI accounts for about 30% of these hospitalizations, while NSTEMI, or NSTE-ACS, accounts for the remaining 70%. […] Despite significant advances in diagnostic techniques and therapeutic strategies, the timely identification and risk stratification of individuals with ACS in the early stage continues to be crucial yet complex, particularly for subgroups with underrecognized risk. […] The 2023 ESC Guidelines for the Management of Acute Coronary Syndromes consolidate recommendations for the entire ACS spectrum into one document, with clinical presentations progressing from oligo/asymptomatic to cardiac arrest and final diagnoses proceeding from unstable angina to NSTEMI to STEMI.

• #4 Acute Coronary Syndromes, Unstable Angina, and Non–ST-Segment Elevation Myocardial Infarction | The Washington Manual of Medical Therapeutics

  https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602371/all/Acute_Coronary_Syndromes__Unstable_Angina__and_Non%E2%80%93ST_Segment_Elevation_Myocardial_Infarction

  The annual incidence of ACS is 780,000 events, with 70% being NSTEMI/UA. […] Among patients with ACS, approximately 60% have UA and 40% have MI (one-third of MIs present with an acute STEMI). […] At 1 year, patients with UA/NSTEMI are at considerable risk for death (6%), recurrent MI (11%), and need for revascularization (50%60%). It is important to note that although the short-term mortality of STEMI is greater than that of NSTEMI, the long-term mortality is similar. […] Patients with NSTEMI/UA tend to have more comorbidities, both cardiac and noncardiac, than STEMI patients. […] Women with NSTEMI/UA have worse short-term and long-term outcomes and more complications compared to men. Much of this has been attributed to delays in recognition of symptoms and underutilization of guideline-directed medical therapy and invasive management.

• #5 Acute Coronary Syndrome (ACS) – Epidemiology Forecast to 2023

  https://www.asdreports.com/news-2894/acute-coronary-syndrome-acs-epidemiology-forecast-2023

  Acute coronary syndrome (ACS) is a serious cardiovascular disease associated with high healthcare costs, frequent recurrences and hospitalizations, and high risks of sudden death and short-term mortality. […] The ACS incidence increases with age and will be a significant public health problem as the elderly population increases around the world. […] In the 7MM, the hospitalized incident cases of ACS will increase from 1.29 million cases in 2013 to 1.47 million cases in 2023 at the rate of 1.40% per year. […] The US constitutes around 40% of the total hospitalized incident ACS cases in the 7MM and will be the market with the highest number of cases during the forecast period. […] For the 7MM, about 33% of the ACS cases were STEMI, 44% were NSTEMI, and 23% were UA.

• #6 Acute Coronary Syndrome (ACS): Causes and Treatment | Doctor

  https://patient.info/doctor/acute-coronary-syndrome-pro

  The burden of ACS is a significant challenge with around 2.3 million UK citizens (1.5 million male and 0.8 million female) living with symptoms or consequences of ACS. […] Around 66,000 people in the UK die due to ACS each year. ACS is the most common cause of premature mortality in the UK. […] Annually, about 25,000 individuals with age less than 75 years old die due to ACS. […] The annual cost of CVDs in the UK is estimated to be 9 billion, and ACS is responsible for about 75% of this economic cost. […] Coronary heart disease is the single biggest cause of death in the UK as well as being a major cause of premature mortality.

• #7 Global epidemiology of acute coronary syndromes | Nature Reviews Cardiology

  https://www.nature.com/articles/s41569-023-00884-0

  This Review provides an epidemiological overview of global mortality from acute coronary syndromes (ACS). Across the regions of the world where data are available, mortality from ACS including premature (age 70 years) mortality from ACS was higher in men than in women. […] In both sexes, age-standardized mortality rates (ASMRs) for ACS in 2020 were highest in lower-income global regions. However, 20 years earlier, ASMRs for ACS were highest in higher-income global regions, including Europe, Northern America and Oceania. […] These higher-income regions have seen progressive reductions in mortality from ACS during the past 20 years, which is in contrast to the more stable levels of mortality from ACS in Asia and in Latin America and the Caribbean. […] In the seven African countries with data available, a small upwards trend in ASMRs for ACS was observed, reflecting an epidemiological transition that is already well advanced in these regions.

• #8 Global epidemiology of acute coronary syndromes | Nature Reviews Cardiology

  https://www.nature.com/articles/s41569-023-00884-0

  Consistent with these changes during the past 20 years were 50% reductions in ASMRs for ACS in the high-income countries of the world compared with 15% reductions in lower-middle-income countries. […] Policymakers need more complete epidemiological data across and within global regions to identify those countries in which the burden of death from ACS is greatest and the need to implement preventive strategies is most pressing. […] The availability of data on mortality from acute coronary syndromes (ACS) is heterogeneous between global regions and is particularly sparse across sub-Saharan Africa and large parts of Asia. […] In all regions of the world with available data, age-standardized mortality rates (ASMRs) for ACS were higher in men than in women. […] In 2020, ASMRs for ACS in both sexes were higher in lower-income regions (Africa, Asia, and Latin America and the Caribbean) than in higher-income regions (Europe, Northern America and Oceania).

• #9 Epidemiology of coronary heart disease and acute coronary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4958723/

  The incidence of CHD has decreased over time in developed countries. […] The experience is often quite different around the world. […] Indeed, CHD is the number one cause of death in adults from low-, middle- and high-income countries. […] Mortality from CHD is expected to increase in developing countries, from an estimated 9 million in 1990 to a projected 19 million by 2020.

• #10 Epidemiology of coronary heart disease and acute coronary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4958723/

  The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). […] Although the mortality for this condition has gradually declined over the last decades in western countries, it still causes about one-third of all deaths in people older than 35 years. […] The 2016 Heart Disease and Stroke Statistics update of the American Heart Association (AHA) has recently reported that 15.5 million persons 20 years of age in the USA have CHD, whilst the reported prevalence increases with age for both women and men and it has been estimated that approximately every 42 seconds, an American will suffer for an MI. […] Although the absolute numbers of CVD deaths have significantly increased since the 1990, the age-standardized death rate has decreased by 22% over the same period, primarily due to a shift in age demographics and causes of death worldwide.

• #11 The Epidemiology of Coronary Heart Disease – Revista Española de Cardiología

  https://www.revespcardiol.org/es-the-epidemiology-of-coronary-heart-articulo-S1885585713003381?redirect=true

  In Spain, a recent methodical analysis of previously published records and official population statistics estimated the following expected distribution of ACS in 2013: 38.2% STEACS, 55.8% NSTEACS, and 6% unclassified ACS. […] Although the incidence of CHD continues to decrease in developed countries, immigration and progressive population aging suggest that the absolute number of coronary events and, consequently, the prevalence of CHD will not decrease and may even increase in the near future.

• #12 Incidence Rate of Acute Coronary Syndrome Including Acute Myocardial Infarction, Unstable Angina, and Sudden Cardiac Death in Nobeoka City for the Super-Aged Society of Japan

  https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-20-1207/_html/-char/en

  Additionally, crude IRs of hospitalized patients with ACS, AMI, and UAP, respectively, were 92.3 (132.8 for men; 58.1 for women), 69.6 (97.9 for men; 45.7 for women), and 22.7 (35.0 for men; 12.4 for women), also showing 75.4% AMI and 24.6% UAP of the ACS incidence. […] The IRs were higher in elderly groups than in the non-elderly groups. […] Higher IRs of ACS were observed in men than in women. […] To the best of our knowledge, the present study was the first paper showing crude and age-adjusted IRs of ACS including AMI, UAP, and SCD in Japan using a city-wide comprehensive registration and the 2015 model population of Japan. […] The present IRs of ACS in Nobeoka were lower than in other countries, which is similar to lower IRs of AMI in Japan being historically observed compared to other countries IRs of AMI in monitoring trends and determinants in cardiovascular disease (MONICA study). […] This is the first study reporting age-specific IRs of ACS including AMI, UAP, and SCD based on a population-based methodology in Japan.

• #13 Prevalence and characteristics of acute coronary syndromes in a department of Cardiology in Senegal

  https://www.oatext.com/prevalence-and-characteristics-of-acute-coronary-syndromes-in-a-department-of-cardiology-in-senegal.php

  Acute coronary syndrome (ACS) is a recent clinical and biological entity that gathers myocardial ischemias. Our objectives were to describe the prevalence, characteristics and management of ACS in a department of cardiology in Dakar, Senegal. […] One hundred and forty-five patients had acute coronary syndromes, with a hospital prevalence of 19.33%. […] The clinical presentation is dominated by acute persistent ST-segment elevation myocardial infarction. Admission times are long and hospital mortality is important. […] In Africa, its prevalence is increasing in relation to the westernization of lifestyle habits, the improvement of socio-economic conditions and the increase in life expectancy. […] In Africa, the prevalence of acute coronary syndrome is increasing with a relatively young age of onset. Improving the management of these conditions in our developing countries requires effective primary prevention through information campaigns, awareness campaigns, and the fight against cardiovascular risk factors.

• #14 Relationship between Cardiovascular Risk Factors and Development of Acute Coronary Syndrome – Biomedical and Pharmacology Journal

  https://biomedpharmajournal.org/vol16no3/relationship-between-cardiovascular-risk-factors-and-development-of-acute-coronary-syndrome/

  In Saudi Arabia, the prevalence of ACS among the population is 8.2%, most of them diagnosed with unstable angina (19.2%). […] Prevention and early detection of risk factors diminished the rate of morbidity and mortality associated with CAD. […] The high prevalence of the cardiovascular disease is due to specific lifestyle characteristics and related risk factors. Many cardiovascular risk factors contribute to ACS. These factors are classified into modifiable and non-modifiable risk factors. […] In the present study, a significant percentage of ACS patients had DM (66%) and HTN (66%) as risk factors, followed by dyslipidemia with a percentage of 58%. […] The main concern of our study was to find the association between cardiovascular risk factors and ACS subtypes, and we focus on six main risk factors.

• #15

  https://scholars.duke.edu/individual/pub1661192

  Acute coronary syndrome prevalence and outcomes in a Tanzanian emergency department: Results from a prospective surveillance study. […] Preliminary data suggests that the burden of acute coronary syndrome (ACS) is high in Tanzania. […] Of 568 participants with chest pain or shortness of breath, 129 (22.7 %) had ACS, including 61 (47 %) with STEMI and 68 (53 %) with non-STEMI. […] Participants with ACS were significantly more likely to die within 30 days than participants without ACS (32.6 % vs 16.4 %, OR 2.45, 95 % CI: 1.56-3.83, p 0.001). […] ACS is common in a northern Tanzanian ED. […] This high prevalence highlights the critical need for enhanced cardiovascular diagnostic and treatment capabilities in Tanzanian and similar African healthcare settings. […] Thirty-day mortality among ACS patients in this study was extremely high (32.6 %), which is substantially higher than ACS mortality rates in high-income countries. […] These findings underscore the need for urgent interventions to address critical gaps in ACS care in African emergency departments. […] By providing the first prospective data on ACS prevalence and outcomes in a Tanzanian ED, this study fills a critical gap in regional epidemiological knowledge.

• #16 Acute Coronary Syndrome | American Heart Association

  https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/acute-coronary-syndrome

  An acute coronary syndrome (ACS) happens when the heart muscle suddenly stops receiving blood. […] Acute coronary syndromes are more likely in people who have certain risk factors. These include: […] Your health care professional can help you understand your risk and what you can do about it.

• #17 Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review | Atlantis Press

  https://www.atlantis-press.com/journals/jegh/125950929/view

  Coronary artery disease is the foremost single cause of mortality and loss of Disability Adjusted Life Years (DALYs) globally. A large number of this burden falls on low and middle income countries accounting for nearly 7 million deaths and 129 million DALYs annually. […] The INTERHEART study showed that there were potentially modifiable risk factors for ACS including raised Apo B/Apo A ratio, current smoking status, psychosocial factors, diabetes, hypertension, abdominal obesity, alcohol consumption, regular physical activity and daily consumption of fruits and vegetables. […] The purpose of this study was to review epidemiological data of CAD and ACS in low, middle and high income countries. This will help in making strategies for primary and secondary prevention of CAD and ACS according to the risk factors present and to availability of resources within the region.

• #18 Relationship between Cardiovascular Risk Factors and Development of Acute Coronary Syndrome – Biomedical and Pharmacology Journal

  https://biomedpharmajournal.org/vol16no3/relationship-between-cardiovascular-risk-factors-and-development-of-acute-coronary-syndrome/

  Most of the smokers patients in our sample were at higher risk for developing STEMI (65.6%) compared to non-smokers. […] HTN along with DM appears to be higher in NSTEMI compared with other ACS subtypes. […] Dyslipidemia also appeared to be a critical risk factor for ACS according to our findings and previous studies. […] Finally Based on our results, having an IHD or a family history of IHD was associated with a higher percentage of UA but particularly IHD as a risk factor was associated with a higher occurrence of STEMI unlike the family history of IHD where most patients presented with NSTEMI.

• #19 Sex Differences in Epidemiology and Risk Factors of Acute Coronary Syndrome in Chinese Patients with Type 2 Diabetes: A Long-Term Prospective Cohort Study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0122031

  Diabetic patients with acute coronary syndrome (ACS) are at higher risk of poor outcome than are non-diabetic patients with ACS. […] Few studies have focused on sex-related ACS incidence, ACS-related mortality or risk factors to affects sex specific ACS in Chinese with Type 2 diabetes mellitus (T2DM). […] Our findings demonstrated sex differences in ACS incidence and risk factors, but not in ACS-related mortality in Chinese patients with T2DM. […] The occurrence of ACS was recorded among 414 patients (19.7%) and ACS-related death among 104 patients (4.9%). […] ACS incidences increased with age in both men and women, and men had a higher prevalence of ACS than women across different age categories and different follow-up periods. […] The transition of ACS incidences from slow to rapid increase were about 5 years earlier in men (at 51-55 years) than in women (55-60 years).

• #20 EpidemiologyEpidemiological trends in acute coronary syndromes: understanding the past to predict and improve the future

  https://www.termedia.pl/Epidemiology-Epidemiological-trends-in-acute-coronary-syndromes-understanding-the-past-to-predict-and-improve-the-future,52,14056,1,1.html

  The total duration of hospital stay among the patients with ACS has decreased significantly in last two decades. […] The median age of AMI patients in the Minnesota Heart Survey was 60, 61, and 60 years in 1985, 1990, and 1995, respectively, in men and 66, 66, and 64 years in women, respectively. […] There has been an apparent shift towards an increase in number of cases with unstable angina and chest pains while the number of patients with AMI especially STEMI has decreased over the period of time. […] The decline in overall rate of AMI and STEMI and increase in unstable angina and NSTEMI over the period of time may be the result of all of the following factors: increased survivorship from prior acute coronary events; an alteration in the clinical course of coronary heart disease, modification of pathophysiology by use of medical treatments; better diagnostic criteria for ACS, excluding those without biomarker evidence of necrosis or ECG change, but including those with more modest extent of myocyte injury and changes in case definition.

• #21 EpidemiologyEpidemiological trends in acute coronary syndromes: understanding the past to predict and improve the future

  https://www.termedia.pl/Epidemiology-Epidemiological-trends-in-acute-coronary-syndromes-understanding-the-past-to-predict-and-improve-the-future,52,14056,1,1.html

  Consistently, there has been a steady decline in CHD mortality in most of the developed countries over the last three decades. […] The trend in ACS incidence has been discussed in previous section and it is estimated that in the populations where mortality has decreased, the reduction in coronary-event rates contributed a half to two thirds and reduction in case fatality accounted for the remainder one third. […] In the United States, the overall CHD mortality declined from 1980 through 2002 by 52% in men and by 49% in women. […] In the GRACE registry, the case fatality between discharge and 6 months was 4.8% for STEMI, 6.2% for NSTEMI, and 3.6% for unstable angina. […] The WHO estimates that CHD mortality will remain the number one killer worldwide in next decades. […] Epidemiological trends in acute coronary syndromes provide insights into the impact of risk factors on disease incidence and the impact of acute and subsequent care on case fatality and other important measures of outcome including re-infarction and heart failure.

• #22 Definitions and Epidemiology of Coronary Functional Abnormalities | ECR Journal

  https://www.ecrjournal.com/articles/definitions-and-epidemiology-coronary-functional-abnormalities?language_content_entity=en

  The prevalence of coronary artery spasm is high in this patient population. […] Studies have shown that coronary functional abnormalities can be found in ~60-70% of patients who have had previous successful myocardial revascularisation procedures and have ongoing/recurrent symptoms. […] Several studies have shown that coronary functional abnormalities are more often found in women compared to men. […] The high number of patients with ANOCA should prompt further assessments in search of functional coronary abnormalities as suggested by the current guidelines.

• #23 You must be logged in as a member to save to your library.

  https://www.acc.org/Latest-in-Cardiology/Articles/2024/06/01/01/42/Cover-Story-Acute-Coronary-Syndromes-New-Perspectives-New-Data

  According to the ACC/AHA guidelines and the ESC guideline, a tailored risk-based approach to angiography is recommended. For patients at very high-risk or high-risk, such as those experiencing ongoing chest pain, dynamic or persistent EKG changes, hemodynamic instability and life-threatening arrhythmias, an early invasive approach is appropriate. […] The ESC guideline also offers an easy-to-remember „A.C.S.” acronym for initial triage and assessment: 'A’ stands for an abnormal ECG, which should be performed within 10 minutes of first medical contact; 'C’ for clinical context, considering symptom presentation and any patient history available; and 'S’ for clinical stability, which is crucial for immediate care decisions, says Wenger. […] A key message in the current ESC ACS guideline is that although there are some sex differences in the epidemiology of ACS, both women and men derive equal benefit from invasive and noninvasive management strategies and, as a general rule, should be managed similarly.

• #24 You must be logged in as a member to save to your library.

  https://www.acc.org/Latest-in-Cardiology/Articles/2024/06/01/01/42/Cover-Story-Acute-Coronary-Syndromes-New-Perspectives-New-Data

  The ACC/AHA revascularization guideline notes that, after controlling for baseline differences in presentation and treatment, women have similar outcomes after revascularization compared with men. […] Despite some progress, too many clinicians are still less aware of and less attentive to women’s heart disease, how it might manifest and how to listen to the complaints of women who present with chest pain, etc.

• #25 Acute coronary syndrome in elderly and frail patients

  https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/acute-coronary-syndrome-in-elderly-and-frail-patients

  Approximately one-third of patients hospitalised for acute coronary syndrome (ACS) are over 75 years of age. Nevertheless, the elderly population represent only 10-20% of patients enrolled in clinical trials. Since they have a mortality rate twice as high as the younger population, their management should be individualised both in the acute phase and at follow-up. […] Patients over 75 years of age are underrepresented in randomised controlled trials, and they have a mortality rate twice as high as younger patients. It is necessary to carefully evaluate individual patient frailty with regard to comorbidities, quality of life, estimated risk/benefit balance of the invasive strategy, as well as patient preference. […] There are no specific guidelines and/or integrated care pathways available for elderly patients with ACS. The identification of different discharge pathways based on the individual risk profiles and degree of family support is important to improving the quality of care and life of these patients.

• #26 JMIR Public Health and Surveillance – Establishing Syndromic Surveillance of Acute Coronary Syndrome, Myocardial Infarction, and Stroke: Registry Study Based on Routine Data From German Emergency Departments

  https://publichealth.jmir.org/2025/1/e66218

  Background: Emergency department (ED) routine data offer a unique opportunity for syndromic surveillance of communicable and noncommunicable diseases (NCDs). […] Objective: This study aimed to develop and validate syndrome definitions for the NCD indicators of acute coronary syndrome (ACS), myocardial infarction (MI), and stroke (STR). […] Results: We analyzed data from 9 EDs, totaling 704,797 attendances from January 1, 2019, to March 5, 2021. Syndrome definitions were based on ICD-10 (International Statistical Classification of Diseases and Related Health Problems 10th Revision-German Modification) diagnoses, chief complaints, and discharge information. We identified 4.3% of all cases as ACS, 0.6% as MI, and 3.2% as STR. […] The internal validation showed accuracy and specificity levels above 96% for all syndrome definitions. The sensitivity was 85.3% for ACS, 56.6% for MI, and 80.5% for STR.

• #27 JMIR Public Health and Surveillance – Establishing Syndromic Surveillance of Acute Coronary Syndrome, Myocardial Infarction, and Stroke: Registry Study Based on Routine Data From German Emergency Departments

  https://publichealth.jmir.org/2025/1/e66218

  Conclusions: We developed NCD indicators for ACS, MI, and STR that showed high levels of internal and external validity. The integration of these indicators into the syndromic surveillance system for EDs could enable daily monitoring of NCD patterns and trends to enhance timely public health surveillance in Germany.

• #28 Acute coronary syndrome in adults: scope of the problem in the UK – The British Journal of Cardiology

  https://bjcardio.co.uk/2017/09/acute-coronary-syndrome-in-adults-scope-of-the-problem-in-the-uk/

  Acute coronary syndrome (ACS) accounts for a substantial number of admissions to UK hospitals. […] The risk of future fatal and non-fatal cardiovascular events following AMI is high. […] Quality indicators for AMI allow the evaluation of care, and their attainment is negatively associated with mortality. […] A UK study using Hospital Episode Statistics (HES) reported a decrease, between 2002 and 2010, in the age standardised AMI event rate per 100,000 population in men of 33% from 230 (95% confidence interval [CI] 228 to 232) to 154 (95% CI 153 to 155) and in women of 31% from 95.4 (95% CI 94.5 to 96.3) to 66.0 (95% CI 65.3 to 66.7). […] Data from MINAP suggest that between 2003 and 2010 the risk of in-hospital mortality from AMI halved. […] However, the rates of decline are unequal across age bands, determined by comorbidity, AMI type and associated with the receipt of guideline-indicated treatments.

• #29 Acute coronary syndrome in adults: scope of the problem in the UK – The British Journal of Cardiology

  https://bjcardio.co.uk/2017/09/acute-coronary-syndrome-in-adults-scope-of-the-problem-in-the-uk/

  According to the BHF Heart Statistics, in 2014, coronary heart disease accounted for 69,163 deaths in the UK, of which the highest numbers for men were for the ages between 75 and 84 years (13,421) and for women for the ages greater than 85 years (13,985). […] Registry-based studies report a cumulative risk of death following AMI (12.1% at six months vs. 39.2% at four years). […] An invasive coronary strategy for the management of AMI is guideline recommended and associated with improved clinical outcomes. […] For NSTEMI, there is evidence that an invasive coronary strategy (coronary angiography, PCI and coronary artery bypass graft [CABG]) significantly explained the decline in rates of death in the UK. […] Increasing and maintaining public and physician awareness of ACS symptoms and treatments is a key to improving care and outcome in this population.

• #30 Acute coronary syndrome in adults: scope of the problem in the UK – The British Journal of Cardiology

  https://bjcardio.co.uk/2017/09/acute-coronary-syndrome-in-adults-scope-of-the-problem-in-the-uk/

  Quality indicators for AMI have recently been developed. These can be applied to patients with ACS in the UK for the evaluation of care, and their attainment is negatively associated with mortality. […] Scientific advances are required to enable a greater understanding of the survivorship trajectories of patients with ACS.

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