Pedro Gabriel Melo de Barros e Silva et al. Otavio Berwanger Elizabete Silva dos Santos Antônio Carlos Sobral Sousa … Margaret Assad Cavalcante Pedro Beraldo de Andrade Fernando Carvalho Neuenschwander Hugo Vargas Filho Jorge Ilha Guimarães Jadelson Andrade Angelo Amato Vincenzo de Paola Marcus Vinicius Bolivar Malachias Luiz Alberto Piva e Mattos Dalton Bertolim Precoma Fernando Bacal Oscar Pereira Dutra
Abstract
Background
There is lack of prospective data on evolution within one year of acute coronary syndromes (ACS) in a representative population of Brazilian patients.
Objectives
To assess the prescription of evidence-based therapies, the incidence of severe outcomes and the predictors for these outcomes in a multicenter Brazilian registry of ACS patients.
Methods
The ACCEPT is a prospective observational study, which included patients hospitalized with a diagnostic of ACS in 47 Brazilian hospitals. The patients were followed for a 1 year and data were collected on the medical prescription and the occurrence of major cardiovascular events (cardiovascular mortality, reinfarction and cerebrovascular accident – CVA). Values of p < 0.05 were considered statistically significant.
Results
A total of 5,047 patients were included in this registry from August 2010 to April 2014. The diagnosis of ACS was confirmed in 4,782 patients (94.7%) and, among those, the most frequent diagnosis was ACS with ST segment elevation (35.8%). The rate of major cardiovascular events was 13.6 % within 1 year. Adherence to prescription of evidence-based therapy at admission was of 62.1%. Age, public service, acute myocardial infarction, CVA, renal failure, diabetes and quality of therapy were associated independently with the occurrence of major cardiovascular events.
Conclusions
During the one-year follow-up of the ACCEPT registry, more than 10% of the patients had major cardiovascular events and this rate ranged according with the quality of therapy. Strategies must be elaborated to improve the use of evidence-based therapies to minimize the cardiovascular events among the Brazilian population. (Arq Bras Cardiol. 2020; 114(6):995-1003)