Epidemiologic study of use of resources in patients with unstable angina: The EARISA Registry

Aim The EARISA Registry was designed to describe diagnostic and therapeutic resources used in Italian cardiology centers for patients with the epidemi ologically most relevant cardiac diseases. This article focuses on patients with unstable angina; characteristics associated with invasive procedures were specifically analyzed. Methods and Results Information was collected over a 2-week period on 1420 patients with unstable angina discharged from 308 cardiology centers. The m ean length of stay was 9 +/- 6 days; 51% of patients were admitted to a cor onary care unit (mean length of stay, 4 +/- 3 days). Noninvasive procedures included echocardiography (64%), Hotter monitoring (25%), exercise stress testing (24%), and echocardiographic stress testing or nuclear imaging (7%) . Invasive procedures were coronary angiography (39%) and percutaneous tran sluminal coronary angioplasty or coronary artery bypass grafting (13%). Uns table angina had a greater impact on invasive procedures than acute myocard ial infarction. Variables independently associated with a higher rate of co ronary angiographic procedures were younger age, higher technologic level o f the hospital, and need for intravenous therapy; Conclusion In Italy, approximately half the patients with unstable angina a re admitted to hospitals without catheterization laboratories or cardiac su rgery facilities. This fact supports the concept that treatments that can b e administered in all types of hospitals are more likely to affect the outc ome of patients with unstable angina. Overall, the rates of coronary angiog raphy and revascularization procedures appeared tow, and the setting where cardiologists practice, rather than patient characteristics, is the major d eterminant of the care given to patients with unstable angina.