Acute coronary syndromes observed from an international perspective.

I love to read studies that compare disease presentation, management, and outcome from an international perspective. Perhaps this interest is the result of factors present in my own life, i.e. frequent contact with family and close friends who live outside the United States. For nearly 40 years, I have maintained close contact with colleagues and members of my spouse’s family in Denmark. Of course, a common topic of conversation with these individuals is the difference in concepts, expectations and delivery of healthcare between the United States and Denmark. Consequently, my interest is piqued whenever I read a study that reports comparative international data concerning disease presentation and management. Two such studies are reported in this issue: Management of acute coronary syndromes — variations in practice and outcome: findings from the Global Registry of Acute Coronary Events (GRACE) and, a prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean Basin: The Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). The GRACE Registry is a multinational (14 countries) registry involving 95 hospitals. The Euro Heart Survey ACS involved 103 hospitals in 25 countries. All of the hospitals in both studies had active cardiology services with busy coronary care units and each hospital entered consecutive patient data from individuals who were admitted with a subsequently confirmed diagnosis of acute coronary syndrome. The data collection process employed by these two registries adhered to previously suggested guidelines for the performance of registry studies as suggested in an earlier editorial (see Table 1). This issue contains the initial report from the GRACE and Euro Heart Survey ACS registries based on information collected from approximately 11 000 patients with acute coronary syndromes in each study. Approximately 40% of the patients in