STEMI and NSTEMI: Real-world Study in Mexico (RENASCA).

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Mexico has the highest adult mortality from acute myocardial infarction (AMI) among OECD countries.
• The RENASCA IMSS study identified a high-risk AMI population with suboptimal reperfusion rates.

Purpose of the Study:

• To describe the clinical presentation, treatment, and outcomes of acute coronary syndromes (ACS) within the Mexican healthcare system (IMSS).

Main Methods:

• A nationwide, prospective, longitudinal-cohort study (RENASCA IMSS) involving 21,827 patients across 177 hospitals.
• Data collected via an electronic database included clinical characteristics, risk factors, reperfusion strategies, and outcomes.
• Rigorous data calibration ensured over 80% accuracy for variables and cases.

Main Results:

• The study enrolled 21,827 patients (average age 63.2 years, 75% male) with prevalent risk factors like hypertension (60.5%) and smoking (46.8%).
• ST-elevation myocardial infarction (STEMI) constituted 73.2% of cases.
• The 'Code Infarction' strategy significantly improved reperfusion therapy (34.9% to 71.4%) and reduced mortality (21.1% to 9.4%) in STEMI patients.

Conclusions:

• The RENASCA IMSS study is the largest real-world ACS study in Mexico, confirming a high-risk profile in the Mexican population.
• STEMI patients faced higher mortality and complications, but the 'Code Infarction' initiative demonstrated improved outcomes.
• Further efforts are needed to optimize ACS management and reduce mortality in Mexico.