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Epidemiology and patterns of care of patients admitted to Italian Intensive Cardiac Care units: the BLITZ-3 registry

Casella, Gianni; Cassin, Matteo; Chiarella, Francesco; Chinaglia, Alessandra; Conte, Maria R; Fradella, Giuseppe; Lucci, Donata; Maggioni, Aldo P; Pirelli, Salvatore; Scorcu, Giampaolo; Visconti, Luigi Oltronaon behalf of the BLITZ-3 Investigators

Journal of Cardiovascular Medicine: June 2010 - Volume 11 - Issue 6 - p 450–461
doi: 10.2459/JCM.0b013e328335233e
Original articles

Background Intensive cardiac care units (ICCUs) have shifted from the observation of patients with myocardial infarction to the care of different acute cardiac diseases. However, few data on such an evolution are available.

Methods and results From 7 to 20 April 2008, 6986 consecutive patients admitted to 81% of Italian ICCUs were prospectively enrolled. Patients observed were mainly elderly men (median age 72 years) with several co-morbidities. Most of them were triaged to ICCU from the emergency room, but 15% of admissions were transfer-in from other hospitals. Several diagnostic and therapeutic procedures were applied (78% had echocardiography and 35% coronary angiography) during the ICCU stay [median length 4 days, interquartile range (IQR) 2–5]. The discharge diagnosis was ST-elevation acute coronary syndrome (ACS) in 21%, non-ST-elevation ACS in 31%, acute heart failure (AHF) in 14% and other acute non-ACS, non-AHF cardiac diseases in 34%. Of those with ST-elevation ACS, 60% received reperfusion (15% fibrinolysis and 45% primary percutaneous coronary intervention). The overall in-ICCU crude mortality was 3.3%.

Conclusion The BLITZ-3 survey provides a unique snapshot of current epidemiology and patterns of care of patients admitted to ICCUs. Although ACS still remains the most frequent admission diagnosis, the number of non-ACS patients is substantial. However, the correct standard of care for these non-ACS patients has to be defined.

aCardiology Department, Maggiore Hospital, Bologna, Italy

bCardiology Department, Santa Maria degli Angeli Hospital, Pordenone, Italy

cCardiology Department, Santa Corona Hospital, Pietra Ligure, Italy

dCardiology Department, Maria Vittoria Hospital, Torino, Italy

eCardiology Department, Infermi Hospital, Rivoli, Italy

fCardiology Department 1, Careggi Hospital, Italy

gANMCO Research Center, Firenze, Italy

hCardiology Department, Istituti Ospitalieri, Cremona, Italy

iCardiology Department, G. Brotzu-S. Michele Hospital, Cagliari, Italy

jCardiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

*See Acknowledgements section for a complete list.

Received 29 July, 2009

Revised 22 September, 2009

Accepted 9 November, 2009

Correspondence to Aldo P. Maggioni, MD, BLITZ-3 Coordinating Center, Research Center of the Italian Association of Hospital Cardiologists (ANMCO), Via La Marmora 34, 50121 Firenze, Italy Tel: +39 055 5101361; fax: +39 055 5101320; e-mail:

© 2010 Italian Federation of Cardiology. All rights reserved.