EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q1IsyourInstitution:
Répondues:47 Ignorées:0
Auniv ersity
hospital
Apriv ate
hospital
Othertype
ofhospital
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Auniversityhospital
80,85%
Aprivatehospital
6,38%
3
Othertypeofhospital
12,77%
6
Total
38
47
1/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q2YouremailAddressis:
Répondues:45 Ignorées:2
2/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q3Wouldyoubecomfortableifwe
acknowledgeyourcentreintheEuropace
JournalandontheWebsite
Répondues:47 Ignorées:0
Yes
No
0%
20%
40%
60%
Choixderéponses
Réponses
Yes
95,74%
No
4,26%
Total
80%
100%
45
2
47
3/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q4Doyouhavecardiacsurgeryatyour
institution
Répondues:47 Ignorées:0
Yes
No
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Yes
80,85%
38
No
19,15%
9
Total
47
4/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q5Numberofimplantations(sumofnew
implantsandreplacements)atyour
institutionlastcalendaryear:
Répondues:47 Ignorées:0
None
1-99
100-199
200-399
400ormore
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
None
2,13%
1
1-99
10,64%
5
100-199
8,51%
4
200-399
42,55%
20
400ormore
36,17%
17
Total
47
5/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q6TotalNumberofcatheterablations(all
typesofarrhythmia)atyourinstitutionlast
calendaryear:
Répondues:47 Ignorées:0
None
1-99
100-199
200-399
400ormore
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
None
10,64%
5
1-99
19,15%
9
100-199
14,89%
7
200-399
34,04%
16
400ormore
21,28%
10
Total
47
6/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q7NumberofPacemakerimplantations
(IncludingCRT-Ps)atyourinstitution
(includingboxchanges)lastcalendaryear
Répondues:47 Ignorées:0
None
1-99
100-199
200-399
400ormore
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
None
4,26%
2
1-99
8,51%
4
100-199
19,15%
9
200-399
57,45%
27
400ormore
10,64%
5
Total
47
7/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q8Numberofinvasivecoronary
interventionprocedures
(angioplasty/stenting)peryearinyour
institutionaverages:
Répondues:43 Ignorées:4
None
Upto100
101–500
501–1000
>1000
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
None
4,65%
2
Upto100
6,98%
3
101–500
6,98%
3
501–1000
23,26%
10
>1000
58,14%
25
Total
43
8/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q9HowmanyAFpatientsonNOACs(i.e.,
dabigatran,rivaroxabanorapixaban)who
sufferedanacutecoronarysyndrome
(ACS)haveyouseeninyourclinical
practicesofar?
Répondues:43 Ignorées:4
None
≤50patients
51-100
patients
>100patients
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
None
25,58%
11
≤50patients
48,84%
21
51-100patients
9,30%
4
>100patients
16,28%
7
Total
43
9/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q10Whatisthepreferredstrategyinyour
centreforAFpatientspresentingwith
STEMIwithinanoptimaltimeframefor
intervention,whoarealreadytaking
warfarinoraNOAC?
Répondues:43 Ignorées:4
10/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
ForAFpatientstakingaVitam inKantagonist(VKA)
Oneansw er
persection
0%
20%
40%
60%
80%
100%
PrimaryPCIwithuninterruptedwarfarinregardlessoftheINRvalue
PrimaryPCIwithuninterruptedwarfarinonlyiftheINRisbelow(please,statethec ut-offvalue)
Fibrinolytic therapy
Conservativetreatment
11/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
ForAFpatientstakinganoveloralanticoagulant(NOAC)
Oneansw er
persection
0%
20%
40%
60%
80%
100%
PrimaryPCIwithuninterruptedNOAC
PrimaryPCIwithtemporaryNOACdisc ontinuation
Fibrinolytic therapy
Conservativetreatment
ForAFpatientstakingaVitaminKantagonist(VKA)
PrimaryPCIw ithuninterrupted
w arfarinregardlessoftheINR
v alue
One
PrimaryPCIw ithuninterruptedw arfarinonlyif
theINRisbelow (please,statethecut-offv alue)
58,14%
34,88%
12/31
Fibrinolytic
therapy
Conserv ativ e
treatment
Total
6,98%
0%
43
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
One
answerper
sec tion
58,14%
25
34,88%
15
6,98%
3
0%
0
43
ForAFpatientstakinganov eloralanticoagulant(NOAC)
PrimaryPCIw ith
uninterruptedNOAC
Oneanswerper
sec tion
PrimaryPCIw ithtemporaryNOAC
discontinuation
37,21%
16
55,81%
24
13/31
Fibrinolytic
therapy
6,98%
3
Conserv ativ e
treatment
Total
0%
0
43
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q11Whichperi-proceduralantithrombotic
medicationdoyoupreferablychoosefor
yourAFpatientsalreadyunderVKA
treatmentundergoingprimaryPCIfor
STEMI(please,tickallmedicationsyouuse
ontopofaVKA):
Répondues:43 Ignorées:4
No
additional
antithromb...
Aspirin
Clopidogrel
Prasugrelor
Ticagrelor
Heparin
(unfractionat
edorLMWH)
GPIIb/IIIa
inhibitors
Idonot
personally
perform...
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Noadditionalantithrombotic medic ation
4,65%
Aspirin
83,72%
36
Clopidogrel
69,77%
30
PrasugrelorTic agrelor
23,26%
10
Heparin(unfrac tionatedorLMWH)
32,56%
14
GPIIb/IIIainhibitors
6,98%
3
Idonotpersonallyperforminvasivec oronaryproc edures(angioplasty/stenting)andc annotanswerthisquestion
2,33%
1
Nombretotalderépondants:43
14/31
2
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q12Whichperi-proceduralantithrombotic
medicationdoyoupreferablychoosefor
yourAFpatientsunderNOACtreatment
undergoingprimaryPCIforSTEMI(please,
tickallmedicationsyouuseontopofa
NOAC):
Répondues:43 Ignorées:4
No
additional
antithromb...
Aspirin
Clopidogrel
Prasugrelor
Ticagrelor
Heparin
(unfractionat
edorLMWH)
GPIIb/IIIa
inhibitors
Idonot
personally
perform...
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Noadditionalantithrombotic medic ation
11,63%
5
Aspirin
74,42%
32
Clopidogrel
67,44%
29
PrasugrelorTic agrelor
16,28%
7
Heparin(unfrac tionatedorLMWH)
30,23%
13
GPIIb/IIIainhibitors
9,30%
4
Idonotpersonallyperforminvasivec oronaryproc edures(angioplasty/stenting)andc annotanswerthisquestion
2,33%
1
Nombretotalderépondants:43
15/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q13Doyouroutinelytemporarilystoporal
anticoagulanttherapyinyourAFpatient
presentingwithanNSTE-ACS?
Répondues:39 Ignorées:8
Yes,alw ays
Yes,aVKA
Yes,aNOAC
No
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Yes,always
35,90%
14
Yes,aVKA
10,26%
4
Yes,aNOAC
20,51%
8
No
33,33%
13
Total
39
16/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q14Howdoyoucommonlyestimatethe
risksofAF-relatedthromboembolic
events,ischemiceventsandbleedingin
AFpatientspresentingwithaNSTE-ACS?
Répondues:39 Ignorées:8
Using
common
clinical
sense
TheGRACE
score
TheTIMI
score
The
CRUSADE
score
The
ACUITY/HORIZO
NSderiv ed...
TheCHADS2
score
17/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
The
CHA2DS2VASc
score
TheHASBLED
score
Other
(please,
state)
0%
20%
40%
60%
TheriskofAF-relatedthromboembolic events
80%
100%
Theriskofisc hemic events
Theriskofbleeding
TheriskofAF-related
thromboembolicev ents
Theriskofischemic
ev ents
Theriskof
bleeding
Nombretotalde
répondants
Usingc ommonc linic alsense
61,11%
11
77,78%
14
61,11%
11
36
TheGRACEsc ore
17,65%
3
82,35%
14
0%
0
17
TheTIMIsc ore
0%
0
73,33%
11
33,33%
5
16
TheCRUSADEsc ore
0%
0
25%
1
75%
3
4
TheACUITY/HORIZONS
derivedsc ore
0%
0
50%
2
50%
2
4
TheCHADS2sc ore
100%
9
0%
0
11,11%
1
10
TheCHA2DS2-VASc sc ore
100%
36
16,67%
6
5,56%
2
44
TheHAS-BLEDsc ore
2,94%
1
0%
0
97,06%
33
34
0%
0
0%
0
0%
0
0
Other(please,state)
18/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q15Whatfirst-linepharmacological
therapydoyoupreferablyuseinAF
patientspresentingwithaNSTE-ACSwho
arealreadytakingaVKAoraNOAC
(please,tickallmedicationsyouuse):
Répondues:39 Ignorées:8
No
additional
antithromb...
Aspirin
Clopidogrel
Prasugrelor
Ticagrelor
Heparin
(unfractionat
edorLMWH)
GPIIb/IIIa
inhibitors
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Noadditionalantithrombotic medic ation
0%
Aspirin
76,92%
30
Clopidogrel
74,36%
29
PrasugrelorTic agrelor
17,95%
7
Heparin(unfrac tionatedorLMWH)
30,77%
12
GPIIb/IIIainhibitors
0%
Nombretotalderépondants:39
19/31
0
0
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q16Whichaccessroute(puncturesite)is
usedatyourcentreinAFpatientsona
VKA/NOAC,undergoingcoronary
angiographyoraPCIwithstenting?
Répondues:39 Ignorées:8
Femoral
Radial,
alw ays
Radial,if
theoperator
hasadequa...
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Femoral
17,95%
7
Radial,always
38,46%
15
Radial,iftheoperatorhasadequateexperienc e
43,59%
17
Total
39
20/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q17Whichstenttypeispreferablyusedat
yourcentreforprimaryPCIinAFpatients
withSTEMI,takingaVKA/NOAC?
Répondues:39 Ignorées:8
OtherStent
(seebelow )
Drug-eluting
stents
Drug-eluting
stents,if
therisko...
Bare-metal
stents
Otherstents
(please,
statew hic...
Wedonot
hav ea
specific...
Other(See
below )
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
OtherStent(seebelow)
0%
0
Drug-elutingstents
12,82%
5
Drug-elutingstents,iftheriskofbleedingwithsubsequenttripletherapyisnottoohigh
12,82%
5
Bare-metalstents
53,85%
21
Otherstents(please,statewhic hone)
2,56%
1
Wedonothaveaspec ific strategyforthesepatients
15,38%
6
Other(Seebelow)
2,56%
1
Total
39
21/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q18Whichofthefollowingtreatment
modalitiesdoyouuseinyourclinical
practiceregardingAFpatientspresenting
withaNSTE-ACS,whoaretakinga
VKA/NOAC?
Répondues:39 Ignorées:8
Inv asiv e
strategies
(coronary...
Bare-metal
stentsare
preferred...
Soleballoon
angioplasty
insteadof...
Bypass
surgery
insteadof...
Nospecific
measure
taken
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Invasivestrategies(c oronaryangiographyandrevasc ularization)shouldbedelayedaslongaspossibleinsuc hpatients
25,64% 10
Bare-metalstentsarepreferredabovedrug-elutingstentstoshortenexposuretodualortripletherapy
74,36% 29
Soleballoonangioplastyinsteadofstentimplantationshouldbec onsideredinAFpatientsathighbleedingriskrequiringtriple
therapy
17,95%
7
BypasssurgeryinsteadofPCIstentingshouldbec onsideredinAFpatientsathighbleedingriskwithtripletherapy
15,38%
6
Nospec ific measuretaken
10,26%
4
Nombretotalderépondants:39
22/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q19Doyouroutinelycontinuewithtriple
therapy(thatis,anoralanticoagulantplus
twoantiplateletdrugs)inallpatientswith
AFandSTEMIwhounderwentPCIwith
stenting?
Répondues:39 Ignorées:8
Yes
No,Iuse
triple
therapyon...
No,Iuse
triple
therapyon...
No,Iuse
triple
therapyon...
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
41,03%
16
Yes
15,38%
6
No,IusetripletherapyonlyinAFpatientsatmoderate-to-highriskofthromboembolic eventsregardlessofthebleedingrisk.
28,21%
11
No,IusetripletherapyonlyinAFpatientsatmoderate-to-highriskofthromboembolic eventsiftheriskofbleedingisnottoohigh
15,38%
No,IusetripletherapyonlyinAFpatientswithdrug-elutingstentsatmoderate-to-highriskofthromboembolic eventsiftheriskof
bleedingisnottoohigh.
Total
6
39
23/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q20Whichcombination(s)offollowing
drugsdoyoupreferablyusefortriple
therapyinyourAFpatientsafteranACS?
(please,tickalloptionsyouwouldchoose)
Répondues:39 Ignorées:8
Warfarin(or
otherVKA)
w iththeI...
Warfarin(or
otherVKA)
w iththeI...
Dabigatran
150mgbid
Dabigatran
110mgbid
Riv aroxaban
20mgonce
daily
Riv aroxaban
15mgonce
daily
24/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Apixaban
5mg
bid
Apixaban
2.5mgbid
0%
20%
Aspirin+Clopidogrel
40%
Aspirin+Prasugrel
Aspirin+
Clopidogrel
60%
80%
100%
Aspirin+Tic agrelor
Aspirin+
Prasugrel
Aspirin+
Ticagrelor
Nombretotalde
répondants
Warfarin(orotherVKA)withtheINR2.02.5
88,24%
30
17,65%
6
20,59%
7
43
Warfarin(orotherVKA)withtheINR2.03.0
81,25%
13
18,75%
3
25%
4
20
Dabigatran150mgbid
77,78%
7
22,22%
2
22,22%
2
11
Dabigatran110mgbid
87,50%
14
12,50%
2
12,50%
2
18
Rivaroxaban20mgonc edaily
75%
6
37,50%
3
37,50%
3
12
Rivaroxaban15mgonc edaily
83,33%
10
25%
3
16,67%
2
15
75%
3
50%
2
25%
1
6
90,91%
10
18,18%
2
9,09%
1
13
Apixaban5mgbid
Apixaban2.5mgbid
25/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q21Howlongdoyoucontinuetriple
therapyinAFpatientsafterprimaryPCI
withstenting?
Répondues:39 Ignorées:8
9-12months,
regardlessof
thebleedi...
Atleast1
monthfor
bare-metal...
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
15,38%
6
9-12months,regardlessofthebleedingrisk
84,62%
Atleast1monthforbare-metalstentsandatleast3-6monthsfordrug-elutingstents(dependingonthestenttype),partic ularlyifthe
riskofbleedingishigh
33
Total
39
26/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q22Howlongdoyoucontinuedual
therapy(i.e.,anoralanticoagulantplusan
antiplateletdrug)inAFpatientsafter
primaryPCIwithstentingforSTEMI?
Répondues:39 Ignorées:8
12months,
alw ays
1month,if
bare-metal
stentsw er...
Indefinitely
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
12months,always
58,97%
23
1month,ifbare-metalstentswereusedand3-6months,ifdrug-elutingstentswereused
25,64%
10
Indefinitely
15,38%
6
Total
39
27/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q23Howlongdoyoucontinuewithtriple
treatmentinyourAFpatientafteraNSTEACS?
Répondues:39 Ignorées:8
•12months,
alw ays
•1month,
ifbare-metal
stentsw er...
•Indefinitel
y
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
•12months,always
25,64%
10
•1month,ifbare-metalstentswereusedand3-6months,ifdrug-elutingstentswereused
69,23%
27
•Indefinitely
5,13%
Total
2
39
28/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q24Whendoyoure-initiatepreviously
discontinuedNOACtherapyinAFpatients
presentingwithanACSwhounderwent
PCIwithstenting?
Répondues:39 Ignorées:8
Immediately
w hen
parenteral...
Other
Within24
hoursafter
thePCIw i...
>24hours
afterthePCI
w ithstenting
Other
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Immediatelywhenparenteralantic oagulationisstopped
17,95%
7
Other
0%
0
Within24hoursafterthePCIwithstenting
28,21%
11
>24hoursafterthePCIwithstenting
43,59%
17
Other
10,26%
4
Total
39
29/31
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q25Doyoucontinuewiththesameoral
anticoagulantdrugthatpatienthasbeen
takingbeforeACS?
Répondues:39 Ignorées:8
Yes
No,Ioften
sw itchfroma
NOACtoa
VKA
No,Ioften
sw itchfroma
VKAtoaN...
0%
20%
40%
60%
80%
100%
Choixderéponses
Réponses
Yes
64,10%
25
No,Ioftenswitc hfromaNOACtoaVKA
28,21%
11
No,Ioftenswitc hfromaVKAtoaNOAC(please,tic kthepreferredNOAC)
7,69%
Nombretotalderépondants:39
30/31
3
EPWIREonEuropeanManagementStrategyforAcuteCoronarySyndromes(ACS)in
Q26Whenitcomestodualtreatmentpost
ACS,whichantiplateletdrugdoyou
preferablycombinewithwarfarin(orother
VKA)oraNOACinyourAFpatient?
Répondues:39 Ignorées:8
Aspirin
Clopidogrel
Prasugrel
Ticagrelor
0%
20%
40%
Withwarfarin(orotherVKA)
60%
80%
100%
WithaNOAC
Withw arfarin(orotherVKA)
WithaNOAC
Nombretotalderépondants
Aspirin
88%
22
60%
15
37
Clopidogrel
96%
24
48%
12
36
Prasugrel
75%
6
37,50%
3
9
55,56%
5
55,56%
5
10
Tic agrelor
31/31