English summary: DEVELOPMENTS IN THE TREATMENT OF ACUTE CORONARY SYNDROMES (WITH NO ST ELEVATION)

The treatment of acute coronary syndromes has improved dramatically during the last few decades. We studied the use of invasive and medical treatments in two acute coronary syndrome study groups. Both studies were performed in the same tertiary hospital, the first study in 1992-3 and the second one in 2003. According to the present study ACS patients were older (64.0 vs 70.0 years) in 2003. Angiography was performed in 4.7% of patients in 1992-3 and in 43.7% in the 2003 study group. Corresponding results for PCI were 2.4 vs 21.1% and for CABG 0 vs 11.2%. The use of antithrombotic medication became more common. Low molecular weight heparin was used in 27 vs 80%, and both clopidogrel (28%) and GP IIb/IIIa blockers (24%) were newcomers in 2003. The use of statins (11 vs 72%) and ACE inhibitors (19 vs 58%) at discharge increased. Instead, the use of calcium antagonists decreased (42 vs 11%). Hospital mortality was lower in 2003 (8.2 vs 2.8%) and there was a trend for reduced one-year mortality (14.1 vs 9.8%).