ABC | Volume 114, Nº6, June 2020

Special Article Barros and Silva et al. Brazilian Registry of Acute Coronary Syndromes Arq Bras Cardiol. 2020; 114(6):995-1003 Discussion This database is considered the largest prospective Brazilian registry of ACS patients, and showed that more than two thirds of the events are classified as acute myocardial infarction at admission. The patients’ profile indicates a predominance of the male sex (70%), almost one-third of patients with diabetes, and systemic arterial hypertension as the most frequent risk factor (74.6%). Almost 40% of the patients did not receive at least one of the evidence-based therapies at admission and the conformity to recommendations varied according to the federal region, to the type of ACS and to the revascularization strategy adopted. The risk of major cardiovascular events within a year was 13.6 per 100 people/year and, out of the seven factors associated with these events, two are related with the health care characteristics: financing (public vs. private) and quality of therapy (complete or incomplete). The ACCEPT partial results, released in 2013, 10 included 2,584 patients and analyzed 2,485, after the exclusion of non-confirmed cases of ACS. In the present analysis, 2,463 patients were added, totaling 5,047 enrolled patients by the end of the study (4,782 cases of confirmed ACS). In addition Table 1 – Baseline characteristics of the patients included according to the type of acute coronary syndrome Patients’ final diagnosis Unstable Angina (n=1453) AMI without ST elevation (n=1615) AMI with ST elevation (n=1714) Total (n=4782) p-value Age; mean ± SD 63.9 ± 11.9 (n=1449) 64.7 ± 12.4 (n=1603) 60.8 ± 12.4 (n=1702) 63.1 ± 12.4 (n=4754) <0.001 (1) Sex (Female) 588/1453 (40.5%) 489/1615 (30.3%) 460/1714 (26.8%) 1537/4782 (32.1%) <0.001 Transferred from another service (Yes) 179/1451 (12.3%) 393/1614 (24.3%) 803/1713 (46.9%) 1375/4778 (28.8%) <0.001 Healthcare (Supplemental Insurance/Private) 757/1453 (52.1%) 775/1615 (48%) 581/1714 (33.9%) 2113/4782 (44.2%) <0.001 Systolic Arterial Pressure; mean ± SD 138.1 ± 24.1 (n=1452) 137.9 ± 28 (n=1615) 131.5 ± 26 (n=1713) 135.7 ± 26.4 (n=4780) <0.001 (1) Diastolic Arterial Pressure; mean ± SD 81.4 ± 13.9 (n=1452) 81.3 ± 16.4 (n=1615) 80.4 ± 16.4 (n=1713) 81 ± 15.7 (n=4780) 0.142 (1) Heart rate; mean ± SD 74.6 ± 15.3 (n=1452) 77.6 ± 18 (n=1615) 79.4 ± 17.2 (n=1713) 77.4 ± 17 (n=4780) <0.001 (1) Dyslipidemia 971/1453 (66.8%) 915/1615 (56.7%) 734/1713 (42.8%) 2620/4781 (54.8%) <0.001 Previous AMI 507/1451 (34.9%) 535/1614 (33.1%) 267/1713 (15.6%) 1309/4778 (27.4%) <0.001 Angina history 774/1452 (53.3%) 554/1614 (34.3%) 406/1713 (23.7%) 1734/4779 (36.3%) <0.001 Hypertension 1197/1453 (82.4%) 1252/1615 (77.5%) 1116/1713 (65.1%) 3565/4781 (74.6%) <0.001 Family History of Coronary Disease 643/1453 (44.3%) 658/1615 (40.7%) 699/1713 (40.8%) 2000/4781 (41.8%) 0.081 CVA 137/1453 (9.4%) 125/1615 (7.7%) 98/1713 (5.7%) 360/4781 (7.5%) <0.001 Stress and/or Depression 506/1451 (34.9%) 419/1614 (26%) 466/1713 (27.2%) 1391/4778 (29.1%) <0.001 Renal Failure 88/1452 (6.1%) 99/1615 (6.1%) 72/1713 (4.2%) 259/4780 (5.4%) 0.021 Diabetes Mellitus 477/1453 (32.8%) 582/1615 (36%) 453/1713 (26.4%) 1512/4781 (31.6%) <0.001 Diabetes treated with insulin 134/474 (28.3%) 150/582 (25.8%) 84/453 (18.5%) 368/1509 (24.4%) - Heart Failure 180/1452 (12.4%) 156/1615 (9.7%) 87/1713 (5.1%) 423/4780 (8.8%) <0.001 Percutaneous Coronary Intervention 489/1450 (33.7%) 406/1614 (25.2%) 209/1713 (12.2%) 1104/4777 (23.1%) <0.001 CABG 223/1452 (15.4%) 213/1615 (13.2%) 68/1713 (4%) 504/4780 (10.5%) <0.001 Previous use of ASA 861/1453 (59.3%) 703/1615 (43.5%) 383/1713 (22.4%) 1947/4781 (40.7%) <0.001 Abdominal Obesity 531/1452 (36.6%) 552/1615 (34.2%) 521/1713 (30.4%) 1604/4780 (33.6%) 0.001 Sedentary lifestyle 949/1453 (65.3%) 968/1615 (59.9%) 962/1713 (56.2%) 2879/4781 (60.2%) <0.001 Peripheral arterial disease 130/1453 (8.9%) 135/1615 (8.4%) 126/1713 (7.4%) 391/4781 (8.2%) 0.252 Smoking Never 761/1453 (52.4%) 756/1615 (46.8%) 664/1713 (38.8%) 2181/4781 (45.6%) <0.001 Ex-smoker 487/1453 (33.5%) 503/1615 (31.1%) 387/1713 (22.6%) 1377/4781 (28.8%) Current smoker 205/1453 (14.1%) 356/1615 (22%) 662/1713 (38.6%) 1223/4781 (25.6%) P-value: Chi-square test. (1) ANOVA test 998