Lights and (Some) shadows in the management of acute coronary syndrome in Spain: the DIOCLES Study.

In the past few decades, The Spanish Society of Cardiology, and in particular, its Ischemic Heart Disease and Acute Cardiovascular Care Section, has made a notable contribution by creating registries to record the reality of heart disease and its treatment and prognosis in Spain.The Society has participated in or published registries in all areas of cardiology, and its studies on ischemic heart disease have been subsequently by the European Society of Cardiology to calculate the European prevalence of stable angina. In the area of stable ischemic heart disease, the TRECE and AVANCE trials were conducted in the past decade, and in the area of acute ischemic heart disease with or without ST-segment elevation, the PRIAMHO I and PRIAMHO II, DESCARTES and MASCARA trials were also conducted in the past decade .The latter trials showed a progressive improvement in the treatment and prognosis of acute coronary heart disease in Spain. These trials were carried out following a strict methodology and with quality controls, allowing well-documented conclusions to be drawn. The DIOCLES trial (from the Spanish: Description of ischemic heart disease in Spain) was recently published by Barrabés et al in Revista Española de Cardiologı́a and represents another step forward in this area. This trial is an update of the data collected in the MASCARA trial, which included patients between 2004 and 2005. Since 2005, substantial differences have been introduced in the treatment of ST-segment elevation myocardial infarction (STEMI), ranging from an increase in the number of ‘‘infarction code’’ networks in STEMI, with the consequent rise in the number of in primary percutaneous coronary interventions (PCI), to a radical approach and use of new drugs. The DIOCLES trial was promoted by the Ischemic Heart Disease and Acute Cardiovascular Care Section and by the Spanish Society of Intensive Care, Critical Care and Coronary Units. The main objective was to determine in-hospital and 6-month mortality in patients admitted to hospital with suspected acute coronary syndrome (ACS) in Spain between 10 January 2012 and 15 June 2012 and to record their management. Centers were selected