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Survival after an acute coronary syndrome: 18-month outcomes from the Australian and New Zealand SNAPSHOT ACS study

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The prevalence, morbidity and early and late mortality associated with an acute coronary event all remain substantial in Australia and New Zealand.1 In Australia, ensuring equitable provision of acute cardiac care is a difficult task because of geographic challenges, shared federal and state jurisdictional responsibility for health care, and increasingly complex patient populations.2

Randomised trial data suggest that percutaneous reperfusion for ST elevation myocardial infarction (STEMI) and routine invasive strategies for revascularisation improve outcomes in patients with acute coronary syndromes (ACS), and this has led to public health initiatives that promote access to catheterisation laboratories.3 Patients presenting to hospitals with catheterisation laboratories are more likely to undergo these procedures than those who do not.46 The availability of angiography facilities may be associated with an improvement in mortality,79 although some studies have found no difference.5,1012 It is not clear whether the lower mortality…