Skip to main content
release_alert
Welcome to the new Scholars 3.0! Read about new features and let us know what you think.
cancel

Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry.

Publication ,  Journal Article
Fagundes, A; Berg, DD; Park, J-G; Baird-Zars, VM; Newby, LK; Barsness, GW; Miller, PE; van Diepen, S; Katz, JN; Phreaner, N; Roswell, RO ...
Published in: Circ Cardiovasc Qual Outcomes
August 2022

BACKGROUND: With the improvement in outcomes for acute coronary syndrome (ACS), the practice of routine admission to cardiac intensive care units (CICUs) is evolving. We aimed to describe the epidemiology of patients with ACS admitted to contemporary CICUs. METHODS: Using the CCCTN (Critical Care Cardiology Trials Network) Registry for consecutive medical CICU admissions across 26 advanced CICUs in North America between 2017 and 2020, we identified patients with a primary diagnosis of ACS at CICU admission and compared patient characteristics, resource utilization, and outcomes to patients admitted with a non-ACS diagnosis and across sub-populations of patients with ACS, including by indication for CICU admission. RESULTS: Of 10 118 CICU admissions, 29.4% (n=2978) were for a primary diagnosis of ACS, with significant interhospital variability (range, 13.4%-56.6%). Compared with patients admitted with a diagnosis other than ACS, patients with ACS had fewer comorbidities, lower acute severity of illness with less utilization of advanced CICU therapies (41.3% versus 66.1%, P<0.0001), and lower CICU mortality (5.4% versus 9.9%, P<0.0001). Monitoring alone, without another CICU indication at the time of admission, was the most frequent admission indication in patients with ACS (53.8%); less common indications in patients with ACS included respiratory insufficiency, shock, or the need for vasoactive therapy. Of patients with ACS admitted for monitoring alone, 94.8% did not subsequently require advanced intensive care unit therapies and had a low CICU length of stay (1.5 days [0.9-2.4] versus 2.6 [1.4-5.1], P<0.0001) and CICU mortality (0.6% versus 11.0%, P<0.0001), compared with patients with ACS with an admission indication beyond monitoring. CONCLUSIONS: In a registry of tertiary care CICUs, ACS represent ≈1/3 of all admissions with significant variability across hospitals. More than half of the ACS admissions to the CICU were for routine monitoring alone, with a low rate of complications and mortality. This observation highlights an opportunity for prospective studies to refine triage strategies for lower risk patients with ACS.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

August 2022

Volume

15

Issue

8

Start / End Page

e008652

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Registries
  • Prospective Studies
  • Intensive Care Units
  • Humans
  • Hospital Mortality
  • Coronary Care Units
  • Cardiovascular System & Hematology
  • Acute Coronary Syndrome
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fagundes, A., Berg, D. D., Park, J.-G., Baird-Zars, V. M., Newby, L. K., Barsness, G. W., … CCCTN Investigators, . (2022). Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry. Circ Cardiovasc Qual Outcomes, 15(8), e008652. https://doi.org/10.1161/CIRCOUTCOMES.121.008652
Fagundes, Antonio, David D. Berg, Jeong-Gun Park, Vivian M. Baird-Zars, L Kristin Newby, Gregory W. Barsness, P Elliott Miller, et al. “Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry.Circ Cardiovasc Qual Outcomes 15, no. 8 (August 2022): e008652. https://doi.org/10.1161/CIRCOUTCOMES.121.008652.
Fagundes A, Berg DD, Park J-G, Baird-Zars VM, Newby LK, Barsness GW, et al. Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry. Circ Cardiovasc Qual Outcomes. 2022 Aug;15(8):e008652.
Fagundes, Antonio, et al. “Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry.Circ Cardiovasc Qual Outcomes, vol. 15, no. 8, Aug. 2022, p. e008652. Pubmed, doi:10.1161/CIRCOUTCOMES.121.008652.
Fagundes A, Berg DD, Park J-G, Baird-Zars VM, Newby LK, Barsness GW, Miller PE, van Diepen S, Katz JN, Phreaner N, Roswell RO, Menon V, Daniels LB, Morrow DA, Bohula EA, CCCTN Investigators. Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry. Circ Cardiovasc Qual Outcomes. 2022 Aug;15(8):e008652.

Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

August 2022

Volume

15

Issue

8

Start / End Page

e008652

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Registries
  • Prospective Studies
  • Intensive Care Units
  • Humans
  • Hospital Mortality
  • Coronary Care Units
  • Cardiovascular System & Hematology
  • Acute Coronary Syndrome
  • 1117 Public Health and Health Services