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BioMed Research International
Volume 2017, Article ID 6025470, 9 pages
Review Article

The Difficult Evolution of Intensive Cardiac Care Units: An Overview of the BLITZ-3 Registry and Other Italian Surveys

1Cardiology Department, Maggiore Hospital, Bologna, Italy
2Cardiology Department 1, Careggi Hospital, Firenze, Italy
3Cardiology Department, G. Brotzu Hospital, Cagliari, Italy
4Cardiology Department, Maria Vittoria Hospital, Torino, Italy
5Cardiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

Correspondence should be addressed to Gianni Casella; ti.angolob.lsua@allesac.innaig

Received 1 July 2017; Accepted 3 October 2017; Published 20 November 2017

Academic Editor: Natale Daniele Brunetti

Copyright © 2017 Gianni Casella et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Coronary care units, initially developed to treat acute myocardial infarction, have moved to the care of a broader population of acute cardiac patients and are currently defined as Intensive Cardiac Care Units (ICCUs). However, very limited data are available on such evolution. Since 2008, in Italy, several surveys have been designed to assess ICCUs’ activities. The largest and most comprehensive of these, the BLITZ-3 Registry, observed that patients admitted are mainly elderly males and suffer from several comorbidities. Direct admission to ICCUs through the Emergency Medical System was rather rare. Acute coronary syndromes (ACS) account for more than half of the discharge diagnoses. However, numbers of acute heart failure (AHF) admissions are substantial. Interestingly, age, resources availability, and networking have a strong influence on ICCUs’ epidemiology and activities. In fact, while patients with ACS concentrate in ICCUs with interventional capabilities, older patients with AHF or non-ACS, non-AHF cardiac diseases prevail in peripheral ICCUs. In conclusion, although ACS is still the core business of ICCUs, aging, comorbidities, increasing numbers of non-ACS, technological improvements, and resources availability have had substantial effects on epidemiology and activities of ICCUs. The Italian surveys confirm these changes and call for a substantial update of ICCUs’ organization and competences.