Clinical studyAdherence to evidence-based therapies after discharge for acute coronary syndromes: an ongoing prospective, observational study☆
Section snippets
Methods
Full details of the GRACE rationale and methodology have been published 8, 9, 10. The registry is designed to reflect an unbiased sample of patients with acute coronary syndromes, irrespective of geographic region. Currently, 104 hospitals in 14 countries (Argentina, Australia, Austria, Belgium, Brazil, Canada, France, Germany, Italy, New Zealand, Poland, Spain, United Kingdom, United States) are participating in this observational study. A broad range of hospitals was chosen based on the
Results
Of the 21,408 patients with myocardial infarction or unstable angina, 65% (n = 13,830) were alive at 5 to 12 months after discharge and had adherence data for the therapies in question (Table 1). The median age was 65 years, and 32% (n = 4404) were women. A total of 4662 (34%) patients were discharged with ST-segment elevation myocardial infarction, 4137 (30%) with non–ST-segment elevation myocardial infarction, and 5031 (36%) with unstable angina.
Among patients included in the analysis,
Discussion
Nonadherence to key medications often leads to worsening of the condition being treated, at an estimated annual cost (direct and indirect) to society of U.S. $1000 billion 12, 13. Further, adherence to treatment in the months and years following admission for acute coronary syndromes is essential if patients are to derive the long-term benefit demonstrated in clinical trials (14).
The GRACE project represents a unique opportunity to gain further insights into the question of adherence to
Acknowledgements
The authors would like to express their gratitude to the physicians and nurses participating in GRACE. Further information about the project, along with the complete list of participants, can be found at . Members of the GRACE Scientific Advisory Committee include Keith A. A. Fox, United Kingdom; Joel M. Gore, United States (GRACE Co-Chairs); Kim A. Eagle, United States; Philippe Gabriel Steg, France (GRACE Publication Committee Co-Chairs); Giancarlo Agnelli, Italy;
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The Global Registry of Acute Coronary Events is funded by an unrestricted educational grant from Aventis Pharma, Bridgewater, New Jersey.