Secondary prevention of a Recurrent ACS; Results from the 2004 & 2006 ACSIS Survey Perl L, Behar S, Schwartz R, Mosseri M Meir Hospital and Sheba Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University

Introduction The preventive effects of cardiovascular drugs after an acute coronary syndrome (ACS) are well established, but little is known concerning the characteristics of a recurrent event, if one should occur. We therefore studied the characteristics of an ACS in patients who present with a recurrent ACS (RACS), and the association with secondary preventive drugs.

Methods Data was collected from the 2004 and 2006 ACSIS (Acute Coronary Syndrome Israeli Survey) - a biannual survey on acute myocardial infarction performed in 26 intensive cardiac care units in Israel during a two-month period. In the two surveys, there were 1207 RACS out of 4168 patients over all.

Secondary treatment surveyed: ACEi, beta blockers, statins, platelet inhibitors. Data were analysed and was assessed for survival according to secondary treatment rates according to the following variables: Recurrent vs. first ACS, KILLIP and TIMI risk scores, and other variables. Methods 2

Patients’ Characteristics KILLIP TIMI FACS Age Female MaleGender % of TotalNumberVariableCategory

Results (I)- Treatment Rates

Results (II)-‏ Mortality according to number of drugs P=NS

Results (III)- ‏1 Year Mortality ????? ?????

Results (III)‏ However, when corrected for TIMI scores, there is a trend towards lower mortality in the 3-4 drugs (OR=0.88, CI in the high TIMI score). However, when corrected for TIMI scores, there is a trend towards lower mortality in the 3-4 drugs (OR=0.88, CI in the high TIMI score).

Conclusions In general, RACS patients are under treated with secondary preventive drugs prior to admission. Although initial analysis revealed a trend for a higher short term mortality rate in those who were treated with more drugs, there was no change in mortality when adjusted for confounding factors. After a year….????