Ricardo Wang et al. Fernando Carvalho Neuenschwander Augusto Lima Filho Celsa Maria Moreira … Elizabete Silva dos Santos Helder Jose Lima Reis Edson Renato Romano Luiz Alberto Piva e Mattos Otávio Berwanger Jadelson Pinheiro de Andrade
Background:
The recommendations in guidelines are based on evidence; however, there is a gap between recommendations and clinical practice.
Objective:
To describe the practice of prescribing evidence-based treatments for patients with acute coronary syndrome in Brazil.
Methods:
This study carried out a subanalysis of the ACCEPT registry, assessing epidemiological data and the prescription rate of acetylsalicylic acid, p2y12 inhibitors, antithrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (IAT1RB), and statins. In addition, the quality of myocardial reperfusion in ST-segment elevation myocardial infarction was evaluated.
Results:
This study assessed 2,453 patients. The prescription rates of acetylsalicylic acid, p2y12 inhibitors, antithrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors/IAT1RB, and statins were as follows: in 24 hours – 97.6%, 89.5%, 89.1%, 80.2%, 67.9% and 90.6%; and at six months – 89.3%, 53.6%, 0%, 74.4%, 57.6% and 85.4%, respectively. Regarding ST-segment elevation myocardial infarction, only 35.9% and 25.3% of the patients underwent primary angioplasty and thrombolysis, respectively, within the recommended times.
Conclusion:
This registry showed high initial prescription rates of antiplatelet drugs, antithrombotic drugs, and statins, and lower prescription rates of beta-blockers and angiotensin-converting enzyme inhibitors/IAT1RB. Independently of the class, the use of all drugs decreased by six months. Most patients with ST-segment elevation myocardial infarction did not undergo myocardial reperfusion within the time recommended.