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Spanish Working Group on Ischemic Heart Disease

Testimonial from Prof. Antonio Fernandez-Ortiz (Chairperson)

Acute Coronary Syndromes

Key figures

  • 600 Members
  • Working Group creation date: 1975
  • Mission statement: To improve the quality of care and outcomes of patients with ischemic heart disease in Spain. Actions and strategy of our Working Group are similar to those of the European ACCA but at the national level.
  • Activites :
    • To deliver documents and recommendations based on good clinical practice

    • To review and promote the implementation of the European Clinical Guidelines in our country

    • To promote education, advance of knowledge and research through meetings, courses, surveys, research projects and grants

    • To increase the number and accreditation of acute cardiac care units conducted by cardiologists in our country 

What are your main project/achievements?

Every 2 years, the Spanish Working Group on IHD organizes the International Symposium on Ischemic Heart Diseases. This symposium highlights what is new in the field inviting first-line international experts. Audience is composed by approximately 500 physicians and the symposium is accredited by EBAC and Spanish authorities. Former symposium was held in Oviedo in May 2012 (, and next will be held in Sevilla in May 2014.

In the last two decades, the Spanish Working Group on IHD has organised several temporary registries directed to ascertain the situation and variability in management for ACS patients in our country. The results of these records now serve as reference for the establishment of care in these patients, and can be found among others in the following publications:

  •  Bueno H, Bardají A, Fernández-Ortiz A, Marrugat J, Martí H, Heras M; Investigadores del Estudio DESCARTES. [Management of non-ST-segment-elevation acute coronary syndromes in Spain. The DESCARTES (Descripción del Estado de los Síndromes Coronarios Agudos en un Registro Temporal ESpañol) study]. Rev Esp Cardiol. 2005 Mar;58(3):244-52.
  • Heras M, Bueno H, Bardají A, Fernández-Ortiz A, Martí H, Marrugat J; DESCARTES Investigators. Magnitude and consequences of undertreatment of high-risk patients with non-ST segment elevation acute coronary syndromes: insights from the DESCARTES Registry. Heart. 2006 Nov;92(11):1571-6.
  • Ferreira-González I, Permanyer-Miralda G, Marrugat J, Heras M, Cuñat J, Civeira E, Arós F, Rodríguez JJ, Sánchez PL, Bueno H; MASCARA study research team. MASCARA (Manejo del Síndrome Coronario Agudo. Registro Actualizado) study. General findings. Rev Esp Cardiol. 2008 Aug;61(8):803-16.
  • Ferreira-González I, Permanyer-Miralda G, Heras M, Cuñat J, Civeira E, Arós F, Rodríguez JJ, Sánchez PL, Marsal JR, Ribera A, Marrugat J, Bueno H; MASCARA study group. Patterns of use and effectiveness of early invasive strategy in non-ST- segment elevation acute coronary syndromes: an assessment by propensity score. Am Heart J. 2008 Nov;156(5):946-53.
  • Arós F, Heras M, Vila J, Sanz H, Ferreira-González I, Permanyer-Miralda G, Cuñat J, López-Bescós L, Cabadés A, Loma-Osorio A, Marrugat J; en representación de los investigadores de los registros PRIAMHO I, II y MASCARA. [Reduction in 28 days and 6 months of acute myocardial infarction mortality from 1995 to 2005. Data from PRIAMHO I, II and MASCARA registries]. Rev Esp Cardiol. 2011 Nov;64(11):972-80

In addition the Spanish WG on IHD has promoted several trials and studies such as:  Bueno H, Betriu A, Heras M, Alonso JJ, Cequier A, García EJ, López-Sendón JL, Macaya C, Hernández-Antolín R; TRIANA Investigators. Primary angioplasty vs. fibrinolysis in very old patients with acute myocardial infarction: TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) randomized trial and pooled analysis with previous studies. Eur Heart J. 2011 Jan;32(1):51-60.

Every year, a competitive research grant for young cardiologists in a foreign cardiovascular center is supported by our Working Group .

What are the main issue encountered in your country in the way of acute cardiovascular care disease are managed?

Delivery and access to primary angioplasty for STEMI patients in our country have been in the European lowest position during the past years. This has been mainly attributed to a lack of organisation more than a lack of resources. With this background, Spain joined the Stent for Life initiative in February 2010 with very good results. In 2012, over half of the Spanish regions have organized STEMI networks and the proportion of patients undergoing early coronary reperfusion has increased by means of an exponential grow of primary angioplasty.

What are the main gaps identified and how could that be solved?

The proportion of Acute Cardiac Care units led by cardiologists in our country is lower than that seen in other European countries.
In Spain, many of these units are staffed by intensive care physicians whose criteria and interests may frequently be or not be convergent with cardiologist's. Improving the training and motivation in our young cardiologists will increase clinical vocations and help to equilibrate this situation in our country.

What do you expect from your collaboration with ACCA/ESC?

To promote knowledge and skills for managing acute cardiac diseases in our young cardiologists through training and certification programmes.
To actively participate in scientific European initiatives, such as the ACCA annual congress and other  meetings.
To promote collaborative studies and registries in the field of acute cardiac care.