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

Area of Science:

• Cardiology
• Public Health
• Clinical Research

Background:

• Limited data exists on acute coronary syndrome with ST-elevation (STEMI) therapies and outcomes in Brazil.
• Understanding regional variations in care is crucial for improving STEMI management nationwide.

Purpose of the Study:

• To assess evidence-based therapies, outcomes, and reperfusion rates in Brazilian STEMI patients.
• To identify predictors of not receiving timely reperfusion therapy within a national registry.

Main Methods:

• Analysis of 1553 STEMI patients from the ACCEPT registry, followed for 1 year.
• Evaluation of major adverse cardiovascular events, reperfusion use, and evidence-based therapy prescription.
• Statistical analysis to determine predictors of reperfusion therapy, with p < 0.05 significance.

Main Results:

• Reperfusion rate was 76.8% nationally, with significant regional variation (47.5% North to 80.5% Southeast).
• Major adverse cardiovascular events occurred in 12.5% of patients at 1 year.
• Hypertension, prior myocardial infarction, and treatment in North, Central-West, and Northeast regions predicted not receiving reperfusion.

Conclusions:

• Significant regional disparities in STEMI care adherence were observed across Brazil.
• Systemic arterial hypertension, prior infarction, and geographical region (North, Central-West, Northeast) are independent predictors of delayed reperfusion.
• Addressing these regional and clinical factors is essential for equitable STEMI treatment.