Am Heart J：EPICOR研究有望明确ACS患者的抗血栓药物应用模式

　　欧洲学者正在实施的EPICOR研究将显示急性冠脉综合征（ACS）患者住院期间和出院后的抗血栓药物应用模式，并可借此探讨不同用药模式下临床转归、生活质量和医疗费用的潜在差异。论文于2012年11月21日在线发表于《美国心脏杂志》（Am Heart J）。

　　前瞻性、多中心、观察性EPICOR研究对因ACS住院患者进行为期2年的出院后随访。此项研究的目的在于描述抗血栓药物应用模式，对短期和长期临床转归（缺血和出血性时间）、生活质量以及初始联合治疗相关性经济影响的差异加以评估，并对不同临床环境下治疗持续时间、停药情况及原因进行分析。

　　2010～2011年间已纳入10568例序贯性ACS存活患者；其中ST段抬高心梗和非ST段抬高ACS患者分别为4943和5625例。受试者来自于20个国家的555所医院。对院前和住院期间治疗以及患者转归加以记录，尤其关注抗血栓治疗以及缺血和出血性事件。目前该研究正于24个月计划随访期间登记抗血栓治疗变化和转归情况。

EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study: rationale, design, and baseline characteristics

Background

There is limited information about patterns of use of newer antithrombotic drugs in patients with acute coronary syndromes (ACS) in a real-life setting. The effectiveness, safety and cost-effectiveness of potential combinations during hospitalization, the duration of therapies, interruptions, or discontinuations as well as their reasons and possible consequences are unknown.

Methods

EPICOR (NCT01171404) is a prospective, multinational, observational study on patients discharged after a hospitalization for an ACS with 2-year follow-up. The study is designed to describe the patterns of antithrombotic use and to evaluate potential differences in short- and long-term clinical outcomes (ischemic and bleeding events), quality of life and economic impact associated with initial combinations during hospitalization, and treatment duration, discontinuations, or interruptions and their reasons after discharge in different clinical environments.

Results

Between September 1, 2010, and March 31, 2011, 10,568 consecutive patients surviving an ACS (4943 with ST-segment elevation myocardial infarction, and 5625 with non–ST-segment elevation ACS) were enrolled from 555 hospitals in 20 countries from 4 pre-defined regions: Northern Europe (n = 3,782), Southern Europe (n = 2,337), Eastern Europe (n = 2,380), and Latin America (n = 2,069). Pre- and in-hospital management and outcomes were recorded, with a special focus on antithrombotic therapies and ischemic and bleeding events. Changes in antithrombotic treatments and outcomes are currently being registered during the planned 24-month follow-up.

Conclusion

EPICOR will show current patterns of antithrombotic use during hospitalization and after discharge in ‘real-world’ patients with ACS, allowing exploration of potential differences in clinical outcomes, quality of life, and costs related to the different antithrombotic practice patterns.