BACKGROUND: In 2011 the European Society of Cardiology published the new guidelines for the treatment and management of @entity1187 without elevation of the ST segment (NSTEMI). For the treatment of the syndrome, the use of @entity3075 inhibitors in addition to @entity117 was strongly recommended (evidence IA). We studied the application of this recommendation in the setting of the emergency department in the vast and uneven area of the Italian region Lazio, three years after the release of these drugs in Italy. METHODS: 121 consecutive @entity1 (65% older than 65 years) affected by NSTEMI were recruited between May and July 2013. During the transition in the emergency department data was collected on @entity1 's symptoms, syndrome severity and type _ timing of treatments chosen. Adherence to the guidelines was evaluated considering the number of "good treated" @entity1 : these being the @entity1 that received at least 80% of the main five recommendations on percutaneous coronary intervention (PCI) timing, antiplatelet and anti-coagulant therapy suggested by the European Cardiology Task Force (ESC guidelines, 2011) for the very acute phase of NSTEMI. RESULTS: @entity1 were treated with: 1) 35% of cases with double antiplatelet therapy and anticoagulation (DAPT+AC), 2) 22% of cases with single antiplatelet and anticoagulation (SAPT+AC), 3) 6% of cases with a single antiplatelet therapy (SAPT), 4) 6% of cases with a double antiplatelet therapy (DAPT) and 5) 24% of cases did not receive any therapy. Data on PCI was available for 95 @entity1 and, of these, only 82% of the @entity1 underwent the procedure. The percentage of "good treated" @entity1 were among of 20-40%, depending on PCI timing--as guidelines suggested--was considered as mandatory (20,5%) or as the extreme time limit (40%). Significant differences were found between @entity1 treated in a central hospital with a hemodynamic laboratory active 24/24hr (HUB) and @entity1 treated in the other hospital (SPOKE). HUBs showed a higher percent of "good treated" @entity1 , a higher percentage of early invasive treated and a better adherence to recommended pharmacological therapy. CONCLUSIONS: A significant number of @entity1 did not receive adequate treatment during the emergency department stay. The absence of hemodynamic services increases the risk of inadequate treatment.

A pilot study on the application of the current European guidelines for the management of XXXX without elevation of ST segment (NSTEMI) in the Emergency Department setting in the Italian region Lazio.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['acute coronary syndrome'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['aspirin'] @entity3075 :: ('64805', 'Gene') :: ['P2Y12']
@entity1187 :: (MESH:D054058,Disease) :: ['acute coronary syndrome']
