Abstract 19221: Low Mortality and Rate of Cardiac Events in Patients After Acute Coronary Syndrome Systematically Managed by Office-based Cardiologists in Germany: 1-year Outcomes of the ProAcor Study
Background/Introduction: The ProAcor Study assessed the effectiveness of a structured patient management program over 12 months in patients who were discharged from hospital after an acute coronary syndrome (ACS) into ambulatory cardiology care (36 hospitals, 56 office-based cardiologists).
Methods: The program comprised patient documentation with a specific instrument (BNK cardiac pass with visit scheduling) done jointly by the hospital physician and the office-based cardiologists, the definition of treatment targets and the structured information of patients in order to optimise adherence to therapy.
Results: 992 patients with ACS were included (STEMI 44.3%, NSTEMI 39.5%, unstable angina pectoris UA 15.2%). In these groups, acute intervention PTCA was performed in 98.0%, 91.9% and 81.6% of patients, stent implantation in 98.6%, 95.6% and 92.7%, and coronary artery bypass graft in 0.7%, 2.5% and 3.3%, respectively. Mean hospital stay due to ACS was 6 days (median).
At 12 months, 18 patients (1.8%) had died (among these, 9 due to cardiac event), while for 51 the status was unknown (5.1%). Based on a conservative approach that considered patients with unknown status as dead, 1-year mortality was 6.9%. Further data on non-fatal cardiac events, medication and quality of life (QoL) were collected from 796 patients (79.4%). Recurrent cardiac events were noted in 119 patients (14.9%), with an about equal distribution across STEMI and NSTEMI patients. On the EQ-5D visual analogue scale (0= worst, 100 best state of health) at 3 months as well as 12 months the median value was 80 points with little differences between subgroups. The EQ-5D index score was 0.91 ± 0.18 points at inclusion (STEMI 0.92, NSTEMI 0.90, UA 0.89) and was unchanged at 12 months.
Conclusion: Compared to data based on usual care (e.g. German MONICA registry 13.3%), the 1-year mortality after ACS of only 6.9% in the structured ProAcor patients management program is remarkably low.
Author Disclosures: F. Goss: Research Grant; Modest; AstraZeneca. W. Haerer: None. J. Brachmann: Honoraria; Modest; AstraZeneca. Consultant/Advisory Board; Modest; AstraZeneca. C.W. Hamm: Honoraria; Modest; AstraZeneca. Consultant/Advisory Board; Modest; AstraZeneca. N. Reifart: None. B. Levenson: None.
- © 2015 by American Heart Association, Inc.