Outcomes, Health Policy, and Managed CareVariation in patient management and outcomes for acute coronary syndromes in Latin America and North America: Results from the Platelet IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial☆,☆☆
Section snippets
Patient population
The design and results of the PURSUIT study have been published elsewhere.13 Between November 1995 and January 1997, 10,948 patients were randomized in 726 participating hospitals in 28 countries. Briefly, patients with ischemic chest pain at rest within the previous 24 hours and either creatine kinase subfraction MB (CK-MB) elevation or electrocardiographic changes were randomly assigned in a double-blind manner to placebo or 2 regimens of eptifibatide. Study drug was infused for 72 hours or
Patient characteristics
A total of 585 patients were enrolled in 68 hospitals from 8 Latin American countries and 4358 patients were enrolled in 307 hospitals in North America. Table I depicts the distribution of enrollment by country.Country No. % Mexico 200 34.2 Argentina 151 25.8 Venezuela 93 15.9 Colombia 61 10.4 Chile 46 7.9 Guatemala 20 3.4 Uruguay 9 1.5 El Salvador 5 0.9 Total 585 100.0
Discussion
This study explored the process of care and outcomes of 585 patients treated for non-ST-segment elevation acute coronary syndromes in Latin America. It provides the first international comparison of Latin America as a region with North America (United States and Canada) with respect to these variables. In summary, the findings suggest that patient management in Latin America is more conservative and associated with higher mortality at 1 and 6 months than in North America. These differences in
Acknowledgements
We would like to acknowledge the excellent editorial assistance of Mr John M. Daniel in the preparation of the manuscript.
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Cited by (0)
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Supported by grants from Cor Therapeutics, San Francisco, Calif, and Key Schering Plough, Kenilworth, NJ.
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Reprint requests: Mauricio G. Cohen, MD, Servicio de Cardiología Intervencionista, Hospital Italiano de Buenos Aires, Cervino 3670-7° piso, 1425-Buenos Aires, Argentina. E-mail: [email protected]