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

• Published in: Arquivos brasileiros de cardiologia 2024, Vol.121 (11), p.e20230863
• Main Authors: Ritt, Luiz Eduardo Fonteles, Silva, Pedro Gabriel Melo de Barros E, Darzé, Eduardo Sahade, Santos, Renato Hideo Nakagawa, de Oliveira, Queila Borges, Berwanger, Otavio, Mattos, Luiz Alberto Piva E, Dos Santos, Elizabete Silva, Souza, Antonio Carlos Sobral, Cavalcante, Margaret Assad, de Andrade, Pedro Beraldo, Neuenschwander, Fernando Carvalho, Vargas Filho, Hugo, Guimarães, Jorge Ilha, de Andrade, Jadelson Pinheiro, de Paola, Angelo Amato Vincenzo, Malachias, Marcus Vinícius Bolívar, Précoma, Dalton Bertolim, Bacal, Fernando, Dutra, Oscar Pereira
• Format: Article
• Language: eng ; por
• Subjects: Acute Coronary Syndrome - therapy; Aged; Brazil - epidemiology; Evidence-Based Medicine; Female; Humans; Male; Middle Aged; Myocardial Reperfusion - statistics & numerical data; Registries; Risk Factors; ST Elevation Myocardial Infarction - therapy; Time Factors; Treatment Outcome
• ISSN: 1678-4170; 1678-4170
• DOI: 10.36660/abc.20230863

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