Myocardial Infarction with ST Elevation and Reperfusion Therapy in Brazil: Data from the ACCEPT Registry.

Arquivos brasileiros de cardiologia Pub Date : 2024-12-06 eCollection Date: 2024-01-01 DOI:10.36660/abc.20230863
Luiz Eduardo Fonteles Ritt, Pedro Gabriel Melo de Barros E Silva, Eduardo Sahade Darzé, Renato Hideo Nakagawa Santos, Queila Borges de Oliveira, Otavio Berwanger, Luiz Alberto Piva E Mattos, Elizabete Silva Dos Santos, Antonio Carlos Sobral Souza, Margaret Assad Cavalcante, Pedro Beraldo de Andrade, Fernando Carvalho Neuenschwander, Hugo Vargas Filho, Jorge Ilha Guimarães, Jadelson Pinheiro de Andrade, Angelo Amato Vincenzo de Paola, Marcus Vinícius Bolívar Malachias, Dalton Bertolim Précoma, Fernando Bacal, Oscar Pereira Dutra
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引用次数: 0

Abstract

Background: There is a lack of information from Brazil regarding therapies used and outcomes in patients with acute coronary syndrome with ST elevation (STEMI).

Objectives: To evaluate evidence-based therapies, occurrence of outcomes, reperfusion use, and predictors of not receiving reperfusion in patients with STEMI in a national multicenter registry.

Methods: Patients with STEMI from the ACCEPT registry, with up to 12 hours of symptoms, were followed for 1 year for the occurrence of major adverse cardiovascular events. A significance level of p < 0.05 was applied for all analyses.

Results: In the analysis of 1553 patients, the reperfusion rate was 76.8%, ranging from 47.5% in the North Region to 80.5% in the Southeast Region. The rate of major adverse cardiovascular events was 12.5% at 1 year. The prescription of evidence-based therapies at hospital admission was 65.6%. The presence of hypertension (odds ratio [OR] 1.47; 95% confidence interval [CI] 1.11 to 1.96; p < 0.01); prior acute myocardial infarction (OR 1.81; 95% CI 1.32 to 2.48; p < 0.001); and the North (OR 4.65; 95% CI 2.87 to 7.52; p < 0.001), Central-West (OR 4.02; 95% CI 1.26 to 12.7; p < 0.05), and Northeast Regions (OR 1.70; 95% CI 1.17 to 2.46; p < 0.01) were independent predictors of not receiving reperfusion therapy.

Conclusion: In the 1-year follow-up of the ACCEPT Registry, we were able to verify a wide variation within Brazilian geographical regions regarding adherence to best care practices. The following were independent predictors of not receiving reperfusion therapy: being treated in the North, Central-West, and Northeast Regions; having systemic arterial hypertension; and prior infarction.

巴西心肌梗死ST段抬高和再灌注治疗:来自ACCEPT注册中心的数据。
背景:巴西缺乏关于急性冠状动脉综合征ST段抬高(STEMI)患者使用的治疗方法和结果的信息。目的:在国家多中心登记中评估STEMI患者的循证治疗、结局发生、再灌注使用和不接受再灌注的预测因素。方法:接受登记的STEMI患者,症状持续时间长达12小时,随访1年,观察主要不良心血管事件的发生。所有分析均采用p < 0.05的显著性水平。结果:1553例患者的再灌注率为76.8%,北部地区为47.5%,东南部地区为80.5%。1年时主要心血管不良事件发生率为12.5%。入院时循证治疗处方占65.6%。高血压的存在(优势比[OR] 1.47;95%置信区间[CI] 1.11 ~ 1.96;P < 0.01);既往急性心肌梗死(OR 1.81;95% CI 1.32 ~ 2.48;P < 0.001);北部(OR 4.65;95% CI 2.87 ~ 7.52;p < 0.001),中西部(OR 4.02;95% CI 1.26 ~ 12.7;p < 0.05),东北地区(OR 1.70;95% CI 1.17 ~ 2.46;P < 0.01)是不接受再灌注治疗的独立预测因子。结论:在接受登记的1年随访中,我们能够验证巴西地理区域内对最佳护理实践的依从性存在很大差异。以下是不接受再灌注治疗的独立预测因素:在北部、中西部和东北地区接受治疗;有全身性动脉高血压的;还有先前的梗塞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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