Outcomes of patients presenting with acute coronary syndromes on workdays vs. rest days (SPUM-ACS substudy)

Abstract Introduction Conflicting data exist upon whether patients presenting with acute coronary syndromes (ACS) during on- or off-hours differ regarding outcomes. Moreover, definitions of and vary in literature. The notion a weekend effect increased mortality has been raised, mostly seen relation to lesser use invasive treatment. Purpose This multi-center study investigated the baseline characteristics associated outcomes ACS undergoing angiography on weekdays compared those weekends holidays. Methods Data from prospective SPUM-ACS (Special Program University Medicine Acute Coronary Syndromes Inflammation) Cohort were examined, recruited between 2009 2012. Patients divided into two groups according they presented for workdays (Monday-Friday, 00:00–23:59) rest days (Saturday Sunday, 00:00–23:59, public holidays shared by all centers). Time presentation was defined as time point catheter sheath insertion. Results From total 2168 (21.4% females), 1828 (84.3%) workdays, 340 (15.7%) without difference female/male ratio. On days, more often showed signs advanced heart failure (Killip Class III–IV 3.9% vs. 7.1%, p=0.009). frequently ST-segment elevation (STE-ACS) than non-ST-segment (STE-ACS days: 50.4% 65.0%, p<0.001). In- out-of-hospital delay metrics did not groups, apart symptom onset-to-balloon time, which shorter (598 520 min, p=0.040). There trend towards frequent percutaneous (89.2% 92.6%, p=0.053) surgical (3.3% vs 5.0%, p=0.131) revascularization days. 30-day all-cause higher any (1.75% 3.82%, p=0.007) STE-ACS only (2.39% 4.98%, p=0.019, Fig. 1). Notably, same when comparing Killip III/IV, both (11.27% 20.83%, p=0.119) (14.00% 26.32%, p=0.114). female males (7.46% 2.93%, p=0.042); observed (8.89% 3.98%, p=0.088). Conclusions failure, similar workdays. might contribute early These differences persisted within subgroups III/IV. Interestingly, males. Thus, warrant particular attention. Funding Acknowledgement Type funding sources: Public grant(s) – National budget only. Main source(s): Swiss Science Foundation (SNSF)