EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study: rationale, design, and baseline characteristics

Background : There is limited information about patterns of use of newer antithrombotic drugs in patients with acute coronary syndromes (ACS) in a real-life setting. The effectiveness, safety and cost-effectiveness of potential combinations during hospitalization, the duration of therapies, interruptions, or discontinuations as well as their reasons and possible consequences are unknown. Methods : EPICOR (NCT01171404) is a prospective, multinational, observational study on patients discharged after a hospitalization for an ACS with 2-year follow-up. The study is designed to describe the patterns of antithrombotic use and to evaluate potential differences in short-and long-term clinical outcomes (ischemic and bleeding events), quality of life and economic impact associated with initial combinations during hospitalization, and treatment duration, discontinuations, or interruptions and their reasons after discharge in different clinical environments. Results : Between September 1, 2010, and March 31, 2011, 10,568 consecutive patients surviving an ACS (4943 with ST-segment elevation myocardial infarction, and 5625 with non-ST-segment elevation ACS) were enrolled from 555 hospitals in 20 countries from 4 pre-defined regions: Northern Europe (n = 3,782), Southern Europe (n = 2,337), Eastern Europe (n = 2,380), and Latin America (n = 2,069). Pre- and in-hospital management and outcomes were recorded, with a special focus on antithrombotic therapies and ischemic and bleeding events. Changes in antithrombotic treatments and outcomes are currently being registered during the planned 24-month follow-up. Conclusion : EPICOR will show current patterns of antithrombotic use during hospitalization and after discharge in 'real-world' patients with ACS, allowing exploration of potential differences in clinical outcomes, quality of life, and costs related to the different antithrombotic practice patterns