Acute coronary syndromes in Latin America: lessons from the ACCESS registry

Background: Evidence of the clinical characteristics, treatment and outcomes among Latin American (LA) patients with acute coronary syndromes (ACS) is scarce. Methods: ACCESS, international prospective multicenter registry to evaluate risk stratification, management and outcomes in ACS (unstable ang...

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Bibliographic Details
Authors: Carlos Martínez-Sánchez, Carlos Jerjes-Sánchez, José Carlos Nicolau, Oscar Bazzino, Norka Antepara, Ricardo Mármol, for the ACCESS Investigators
Format: article
Status:Published version
Publication Date:2016
Country:México
Institution:Instituto Tecnológico y de Estudios Superiores de Monterrey
Repository:Redalyc-ITESM
OAI Identifier:oai:redalyc.org:457747918019
Online Access:https://www.redalyc.org/articulo.oa?id=457747918019
https://www.redalyc.org/journal/4577/457747918019/
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https://www.redalyc.org/journal/4577/457747918019/movil
Access Level:Open access
Keyword:Medicina
Unstable angina
Myocardial infarction
Ischemic heart diseas
Acute coronary syndrome
Description
Summary:Background: Evidence of the clinical characteristics, treatment and outcomes among Latin American (LA) patients with acute coronary syndromes (ACS) is scarce. Methods: ACCESS, international prospective multicenter registry to evaluate risk stratification, management and outcomes in ACS (unstable angina or non-ST elevation myocardial infarction UA/NSTEMI or ST elevation myocardial infarction STEMI) in developing countries. Primary endpoint: all-cause death at 1 year; all-cause mortality within 30 days was also recorded, Patients with acute ischemic symptoms within 24 hours of symptoms onset and electrocardiographic evidence of ischemia were enrolled. Coronary artery disease was proved by positive invasive or non-invasive tests.Results: Between 2007 and 2008, 4436 patients with ACS (2562 UA/NSTEMI and 2374 STEMI) from eight LA countries. On admission, acute symptoms were identified in 79 % and 90%, respectively. Both groups had a long delay from symptom onset to hospital arrival. Low access to pharmacological (29%) and mechanical reperfusion (32%) were observed. At admission, rates of evidence-based treatment were low in all groups. The most common in-hospital complications were heart failure (10% UA/NSTEMI and 20% STEMI) and recurrent ischemia (8% and 11%). Mortality at 30 days was 2% and 8% at 1 year. Conclusion: ACCESS registry provides contemporary information of patients with ACS in LA and their hospital management and subsequent clinical outcomes.